Attachment_43 _CDP_Safety_Plan_(COBRATF)(Jan_16).pdf

U.S. Department of Homeland Security Federal Emergency Management Agency Center for Domestic Preparedness

CDP Safety Plan

(COBRATF)

CDP-OP-5001.5

January 2016

REVISION 5

CDP Safety Plan (COBRATF) i Table of Contents CDP-OP-5001.5 Rev. 5 (Jan 16)

CDP Safety Plan (COBRATF) Copy ____ of ____

TABLE OF CONTENTS

Overview

Annex A – Bloodborne Pathogens Plan

Appendix A Classification I Job Listing

Appendix B Classification II Job Listing

Appendix C Personnel Not Covered by the Standard Classification III Job Listing

Appendix D Required Elements of Occupational Exposure to

Bloodborne Pathogens Training

Appendix E Hepatitis B Vaccination Declination Statement

Appendix F Health Record – Chronological Record of Medical Care

Appendix G Sharps Injury Log (SIL)

Appendix H Employee Input for Safety Needles & Syringes

Annex B – Confined Space Program

Appendix A Safety Entry Checklist

Appendix B Confined Space Entry Permit Form

Appendix C Equipment/Fall Equipment Log Sheet

Appendix D Confined Space Analysis Form

Annex C – Fall Protection Program

Appendix A Fall Protection Evaluation Form

Annex D – Fire Prevention Plan

Appendix A Emergency Notification Roster

CDP Safety Plan (COBRATF) ii Table of Contents

Appendix B Structure Evacuation Routes

Appendix C Key Personnel & Duties

Appendix D 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 Lockout/Tagout Form

Appendix B Lockout/Tagout Log Sheet

Annex I – Radiation Plan

Annex J – Respiratory Protection Program

Annex K – Spill Prevention & Response Plan

Annex L – CDP COBRATF Chemical Hygiene Plan

Annex M – CDP COBRATF Toxic Agent Exposure Control Plan

Annex N – COBRATF Biosafety Manual

CDP Safety Plan (COBRATF) Overview

CDP Safety Plan (COBRATF) Overview

1. Introduction

The Chemical, Ordnance, Biological, and Radiological Training Facility (COBRATF) is operated by the Department of Homeland Security (DHS), Federal Emergency Management Agency (FEMA), Center for Domestic Preparedness (CDP). The CDP COBRATF 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 COBRATF. It is part of our daily operations and was established for the protection of our employees, responder students, visitors, property, the environment, 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 (COBRATF) 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 COBRATF 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.

CDP Safety Plan (COBRATF) Overview

4. Violations

Employees (regardless of the source of employment) of the CDP COBRATF who knowingly violate safety and health rules may face disciplinary action up to termination. Responder students of and visitors to the CDP COBRATF 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.

CDP Safety Plan (COBRATF) 1 Annex A Bloodborne Pathogens Rev. 5 (Jan 16)

CDP Safety Plan (COBRATF) Annex A Bloodborne Pathogens Plan

1. Objective

To establish an Exposure Control Plan (ECP) for Bloodborne 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

(1) 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

(1) 29 CFR 1910.1030 – Bloodborne Pathogens

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

(3) 29 CFR 1910.1020 – Access to employee exposure and medical records

(4) CDP Medical Waste Management Plan

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

c. Responsibilities

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

CDP COBRATF.

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

CDP Safety Plan (COBRATF) 2 Annex A

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

(4) Federal Occupational Health Nurse (FOHN). The FOHN will be responsible for overall management and support of the CDP COBRATF Bloodborne 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 bloodborne 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 III to each position under their control or purview. (Appendix 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 COBRATF Safety Training Manager with

CDP Safety Plan (COBRATF) 3 Annex A responsibility for ensuring training to all employees who have potential for exposure to bloodborne pathogens. Safety personnel at the CDP COBRATF 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 D are included in training sessions.

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

(7) Employees

(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 bloodborne pathogen to the first line supervisor, FOHN, safety representative, or other responsible individual.

3. Definitions

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.

CDP Safety Plan (COBRATF) 4 Annex A

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.

i. 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.

l. 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, pericardial 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.

CDP Safety Plan (COBRATF) 5 Annex A

(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

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.

CDP Safety Plan (COBRATF) 6 Annex A

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.

x. 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 HIV, HBV, and other bloodborne pathogens.

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

z. 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.

aa. Classification II - 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, body fluids, or tissues. However, exposure or potential exposure may be required as a condition of employment.

bb. 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.

CDP Safety Plan (COBRATF) 7 Annex A

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

b. The following job descriptions/classifications are generally considered

Classification II, 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:

(1) 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.

CDP Safety Plan (COBRATF) 8 Annex A

(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) No 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 performed 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 COBRATF incinerator.

c. Personal Protective Equipment (PPE):

(1) When there is a possibility of occupational exposure, CDP COBRATF 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

CDP Safety Plan (COBRATF) 9 Annex A

(d) Face shields/masks

(e) Safety 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 COBRATF 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.

CDP Safety Plan (COBRATF) 10 Annex A

(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 torn, 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 HIV 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 blood 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, CDP Safety Plan (COBRATF) 11 Annex A 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 MLTs.

(2) Regulated Medical Waste:

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

(3) Hepatitis B Vaccination:

Any CDP COBRATF 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. (See 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.

3. The circumstances under which the exposure occurred.

CDP Safety Plan (COBRATF) 12 Annex A

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

1. A copy of the OSHA 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:

1. 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:

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

2. The department or work area where the exposure incident occurred.

3. An explanation of how the incident occurred.

6. Communication of Hazards to Employees

a. Training

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

CDP Safety Plan (COBRATF) 13 Annex A

(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.

(5) 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 335-17-30.01 and the CDP Medical 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:

(1) 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 Bloodborne Pathogen Standard or by law.

c. Master Training records, maintained by Safety Training Manager, shall include the following information:

(1) 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.

CDP Safety Plan (COBRATF) 14 Annex A

(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.

(1) 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.

Solicitation shall be documented using Appendix H.

CDP Safety Plan (COBRATF) A-1 Annex A Bloodborne Pathogens Plan Rev. 5 (Jan 16)

CDP-OP-5001.5

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

1. Date:

2. Name of Employee

a. Name 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 PPE Required

CDP Safety Plan (COBRATF) B-1 Annex A

CDP-OP-5001.5

Bloodborne Pathogens Plan (COBRATF) Appendix B Classification II Job Listing

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.

CDP Safety Plan (COBRATF) C-1 Annex A

CDP-OP-5001.5

Bloodborne Pathogens Plan (COBRATF) Appendix C Personnel Not Covered by the Standard Classification III Job Listing

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 perform tasks which involve a perceived risk without retribution.

CDP Safety Plan (COBRATF) D-1 Annex A

CDP-OP-5001.5

Bloodborne Pathogens Plan (COBRATF) Appendix D Required Elements of Occupational Exposure to Bloodborne Pathogens Training

1. Topics covered during the Bloodborne 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 bloodborne diseases.

c. An explanation of the modes of transmission of bloodborne 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

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. Information 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.

i. 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.

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

CDP Safety Plan (COBRATF) D-2 Annex A

CDP-OP-5001.5

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.

CDP Safety Plan (COBRATF) E-1 Annex A

CDP-OP-5001.5

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

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 (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 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 Signature Date

CDP Safety Plan (COBRATF) F-1 Annex A

CDP-OP-5001.5

Bloodborne Pathogens Plan (COBRATF) Appendix F Health Record – Chronological Record of Medical Care

Department of Homeland Security 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 ___ Anti HBC ___ HBs ___ HIV ___ HBs Ag ___ LFT ___ Anti-HCV ___

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.

CDP Safety Plan (COBRATF) F-2 Annex A

6. Source tested:

RPR ___ Anti-HBC ____ HBs ___ HIV ___ HBs Ag ___ LFT ___ Anti-HCV ___

7. Follow up scheduled with physician.

COBRATF FOHN Print and Sign

Records Maintained At: _______________________________________________

Patient's Name: ___________________________________

Sex:_____________

SSN (Last Four): _____________________________

Date of Birth: ___________________

CDP Safety Plan (COBRATF) G-1 Annex A

CDP-OP-5001.5

Bloodborne Pathogens Plan (COBRATF) Appendix G Sharps Injury Log (SIL)

SHARPS INJURY LOG (SIL)

Center for Domestic Preparedness

DATE NAME SS #

(Last Four Only)

Type of Device

Work Area

Narrative

CDP Safety Plan (COBRATF) H-1 Annex A

CDP-OP-5001.5

Bloodborne Pathogens Plan (COBRATF) Appendix H Employee Input for Safety Needles and Syringes

1. Employee Name:

2. Suggestions for Safer Device or Synopsis of Article Reviewed or Product

Report:

CDP Safety Plan (COBRATF) 1 Annex B Confined Space Program Rev. 5 (Jan 16)

CDP-OP-5001.5

CDP Safety Plan (COBRATF) Annex B Confined Space Program

a. In this facility, a confined space is defined as an enclosed space which is large enough and configured so that an employee can bodily enter and perform assigned work; has limited or restricted means for entry or exit;

and is not designed for continuous human occupancy; furthermore, a permit confined space (permit space) has one or more of the following characteristics: it contains, or has a known potential to contain, a hazardous atmosphere, contains a material with the potential for engulfment of an entrant (any confined space that has the potential for engulfment requires the presence of an attendant), has an internal configuration such that an entrant could be trapped or asphyxiated by inwardly converging walls, or a floor which slopes downward and tapers to smaller inwardly converging walls, or a floor which slopes downward and tapers to a smaller cross section, or contains any other recognized serious safety or health hazard.

b. This document contains the procedures for confined space entry. All confined spaces in this facility are identified, and entry and rescue procedures have been determined. Personal Protective Equipment (PPE), air monitoring equipment, and rescue equipment used at this facility are also included.

2. Confined Spaces

a. The CDP Industrial Hygienist (CDP IH), CDP Safety and Occupational Health Manager, and COBRATF Operations and Maintenance (O&M) Safety Manager have conducted a survey of this facility and determined that the locations identified in Appendix D – Confined Space Analysis Form, may be considered confined spaces in some situations. Based on the evaluation made at the time of entry and the work to be performed, the permit issuer will determine the safety precautions to be followed for the specific task required.

Employees who enter confined spaces during work will be trained on the hazards of the confined spaces they enter, the use of air samplers and ventilation equipment if required, and procedures for communicating with their attendants. Attendants will be trained about the hazards of the confined spaces they are attending, the signs, symptoms and consequences of exposure, communication procedures, and procedures to be followed if an entrant needs assistance. In particular, attendants will be trained to not

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enter the confined space to affect a rescue, but to immediately alert rescue personnel. Supervisors will be trained in the above, as well as the operation of the necessary air sampling equipment required by the specific confined space entry procedure. Confined space rescue and training will be in accordance with Occupational Safety and Health Administration

(OSHA) 29 CFR 1910.146.

3. General Confined Space/Permitted Space Entry Procedure

a. General Confined Space

(1) Notify the responsible supervisor that entry into a confined space is necessary.

(2) The supervisor will notify the COBRATF O&M Safety Manager or his/her designated representative that a confined space entry is necessary.

b. Permit Required Confined Space

(1) It is the responsibility of assigned Operations and Maintenance employees to issue permits and to enforce compliance with confined space entry procedures.

Note: Authorized permit issuers are designated in section 6.c.

(2) The permit issuer is responsible for testing the atmosphere and evaluating the hazards of the confined space.

(3) Once evaluated, the permit issuer will post one copy of the confined space entry permit outside the space during the confined space entry. Once, the confined space entry has been completed.

The completed copy of the confined space entry will be filed into the confined space permit file.

(4) In the event a permit has not been issued, entrants should contact their supervisor and request the issuance of a permit. No one is allowed in a confined space until a written permit has been issued.

(5) A pre-entry briefing shall be conducted before entering a confined space. The permit issuer and entrant(s) are involved in the briefing. The attendant(s), rescue team, and supervisor may be involved if required by the permit issuer. The permit issuer will conduct this briefing. The permit issuer will review material from the written plan, details and restrictions, as well as the contents of the entry permit.

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(6) The entry permit must describe all special work which is to be performed within the permitted confined space (welding, cutting, use of solvents, etc.). The permit issuer must evaluate the need for additional local ventilation and air sampling which may be required for special situations.

(7) It is the responsibility of the individual(s) entering a confined space to be sure a confined space entry permit has been issued.

(8) All entrants to a confined space will follow the below procedures:

(a) Follow the specific procedure for isolation and ventilation of the confined space.

(b) Follow the lockout/tagout procedure for the mechanical and electrical hazards in the confined space.

(c) Once the above are complete, the authorized permit issuer will make any necessary atmospheric tests and either completes the required permit or post the results if the space is non-permit required.

(d) Whenever employees enter confined spaces there will always be a trained attendant outside whose duty is to observe the employee working in the confined space to request help in the event of collapse. Attendants are never to enter the confined space to render assistance, although they can extricate personnel using hoists and lines.

4. Testing for Hazardous Atmospheres

a. The permit issuer shall perform air quality testing. This sampling will be performed in accordance with the information provided during training.

Frequency of testing and other testing requirements will be detailed on the entry permit.

b. The permit issuer must determine if the entry calls for respiratory protection and if so must determine the proper type of respiratory protection to be utilized. The permit issuer must also verify that entrants have been properly trained.

c. When the permit is initially issued, the permit issuer must make an assessment for heat/cold stress potential.

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5. Energy Sources

a. All energy sources will be:

(1) Locked out or controlled in accordance with the CDP COBRATF Lockout/Tagout Program (Annex H).

(2) Stored or residual energy must be relieved, disconnected, blanked off, restrained, and otherwise rendered safe. Energy sources subject to re-accumulation, such as capacitors, hydraulic reservoirs, air tanks, steam traps, etc. should be controlled by isolation and locking out.

b. The following are examples of controlling energy sources:

(1) Blanking or Blinding – The absolute closure of a pipe, line, or duct by the fastening of a solid plate (such as spectacle blind or a skillet blind) that completely covers the bore and that of the pipe, line, or duct with no leakage beyond the plate.

(2) Double Block and Bleed – The closure of a line, duct, or pipe by closing and locking or tagging two in-line valves and by opening and locking or tagging a drain or vent valve in the line between the two closed valves.

(3) Line Breaking – The intentional opening of a pipe, line, or duct that is or has been carrying flammable, corrosive, or toxic material, or an inert gas and/or fluid at a volume, pressure, or temperature capable of causing injury.

6. Permit Issuer or His/Her Appointed Representative

a. Training. Only trained permit issuers will issue confined space entry permits. The permit issuer at the CDP COBRATF has been trained in confined space entry procedures which includes the following:

(1) Hazard recognition.

(2) Recognition of the signs and symptoms of exposure to a hazard.

(3) Understanding the consequences of exposure to a hazard.

(4) Communication requirements.

(5) PPE requirements.

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(6) Written permit-required information.

(7) Rescue procedures.

(8) Use of appropriate air testing equipment.

(9) Details of the facility-specific written plan.

(10) Temperature extremes.

b. Duties. The permit issuer has the following duties in our facility:

(1) Conduct a pre-entry briefing session with all employees entering the confined space.

(2) Determine that the entry permit contains the required information before authorizing or allowing entry.

(3) Determine that the necessary procedures, practices, and equipment for safe entry are in effect before allowing entry.

(4) Determine, at appropriate intervals, that entry operations remain consistent with the terms of the entry permit and that acceptable entry conditions are present.

(5) Cancel the entry authorization and terminate entry whenever acceptable entry conditions are not present.

(6) Take the necessary measures for concluding an entry operation such as closing off a permit space, canceling the permit, and ensuring that all work authorized by the permit has been completed.

(7) Take appropriate measures to remove unauthorized personnel who are in or near entry permit spaces, and give the entry permit to the issuing manager or supervisor for permanent filing following completion of work.

c. Permit Issuers

The following individuals have been properly trained and are therefore qualified to issue permits in this facility:

Title

COBRATF O&M Project Manager COBRATF O&M Safety Manager

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CDP IH

CDP Safety and Occupational Health Manager

Note: No other individual may issue a confined space entry permit at this facility.

7. Authorized Entrants

a. Training. Only those individuals that have been trained in confined space entry and stand-by procedures may enter confined spaces in this facility.

Authorized entrants have been trained in:

(1) Hazards that may be faced during entry.

(2) Recognizing the signs and symptoms of exposure to a hazard.

(3) Understanding the consequences of exposure to a hazard.

(4) Communication requirements for confined space entry.

(5) Notifying the attendant when the entrants initiate the evacuation of a permit space.

(6) The use of PPE, such as retrieval lines, respirators, and clothing needed for safe entry and exit.

(7) Ensuring the atmosphere of a confined space is re-tested before entering after an absence.

(8) The external barriers required to protect entrants from external hazards and the proper use of those barriers.

(9) Evacuating a confined space when ordered by the attendant.

(10) Evacuating a confined space when an alarm is activated.

(11) Evacuating a confined space when entrants perceive they are in danger.

(12) Basic atmospheric testing instrumentation.

8. Trained Entrants. The COBRATF O&M Safety Manager will maintain a list of individuals who have met the training requirements and are authorized to enter or act as attendants in confined spaces in this facility. Entries requiring use of air purifying or supplied air respirators shall be done in accordance with the CDP COBRATF Respiratory Protection Program. (Reference Annex J)

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9. Attendants and Attendant Responsibilities

Training. The permit issuer determines the need for an attendant. This determination is based on the review of the written plan and evaluations of the hazards. Whenever an immediately dangerous to life or health atmosphere is present, or an engulfment hazard is present, or converging walls are present, an attendant is mandatory. The attendant is aware of the hazards of the confined space, the actions needed to make the space safe for entry, and the likelihood that any conditions can change. When attendants are required, only trained individuals will be used. Attendants must be trained in:

(1) The duties of the attendant, including the requirement that the attendant must be stationed and remain outside the permit space at all times during entry operations.

(2) Maintaining an accurate count of all persons in the space.

(3) Recognizing potential permit space hazards and the symptoms of exposure to a hazard, and monitoring activities inside and outside the permit space to determine if it is safe for entrants to remain in the space.

(4) Maintaining effective and continuous contact with entrants and have communication with Security and Safety Control.

10. Trained Attendants. In this facility, all individuals listed as being authorized to make confined space entries are trained to be attendants. It is understood that an individual cannot be both an entrant and an attendant at the same time. Being an attendant is a full-time job and no other assignment can be made to these individuals.

11. Rescue Team

a. Non-Entry Rescue

Training. Select individuals at the CDP COBRATF have been identified and trained to be members of the on-site rescue team. Rescue team individuals have been trained in:

(1) The use of PPE, including respirators and rescue equipment necessary for making rescues from the permit spaces in our facility.

(2) Assigned rescue functions.

(3) Authorized entrant training.

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(4) Making confined space rescues at least once every 12 months using mannequins or personnel through representative openings and portals whose size, configuration, and accessibility closely approximate those of the permit spaces from which rescues may be required in the facility.

(5) Rescue equipment use and maintenance.

(6) Cardiopulmonary Resuscitation (CPR).

(7) Automated External Defibrillator (AED).

Note: When required, the on-site medical staff will perform first aid procedures, once the rescue team has performed the rescue. The medical staff will not enter the confined space.

(8) Non-Entry Rescue Retrieval Systems or Methods

To facilitate non-entry rescue, retrieval systems or methods will be used whenever an authorized entrant enters a permit space, unless the retrieval equipment would increase the overall risk of entry or would not contribute to the rescue of the entrant. Retrieval systems will meet the following requirements:

(a) A full-body harness, with a retrieval line attached at the center of the entrant’s back or chest near shoulder level, or above the entrant’s head.

(b) Wristlets may be used in lieu of the full-body harness if the harness is non-feasible or creates a greater hazard and if the use of wristlets is the safest and most effective alternative.

(c) The other end of the retrieval line will be attached to a mechanical device or fixed point outside the permit space in such a manner that rescue can begin as soon as the rescuer becomes aware that the rescue is necessary. The need for a mechanical retrieval device will be determined by the permit issuer.

(9) Safety Data Sheet (SDS) Availability. If an injured entrant is exposed to a substance for which a SDS or other similar written information is required to be kept at the work site, that SDS or written information will be made available to the medical facility treating the exposed entrant.

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A list of individuals that have completed the above detailed training and are therefore authorized to perform rescue functions in this facility is on file in the O&M Contractor’s Safety Office.

b. Entry Rescue

(1) Entry rescue will not be performed by the COBRATF non-entry rescue team unless the team meets the criteria outlined in 29 CFR

1910.146 Appendix F.

(2) Entry rescue may be performed by external agencies based on their internally approved procedures.

12. Personal Protective Equipment. Based upon an evaluation of the CDP

COBRATF’s confined spaces, certain PPE is maintained for employees entering confined spaces. All employees who enter confined spaces must be properly attired to avoid contact with hazardous materials. The O&M Contractor has available items that are required for use in confined space entry.

13. Subcontractors. If subcontractors are utilized to perform operations within a confined space, the subcontractor will comply with applicable OSHA regulations and this program. The written contract will specify that the subcontractor is responsible for the safety and health of their employees.

14. Atmospheric Testing. Prior to an employee entry into a confined space, the

COBRATF O&M…