Bloodborne Pathogens Exposure Control Plan

Transcription

1 Envirnmental Health & Safety Bldbrne Pathgens Expsure Cntrl Plan EOSMS 215 Effective Date: REV: 3.0 Page 1 f 31 Kennesaw State University (KSU) is cmmitted t prviding and maintaining a safe teaching, learning, living, and wrking envirnment fr all members f its cmmunity. Universities have unique wrk envirnments that entail a variety f peratins and activities, invlving wrking with hazardus materials. Sme persnnel, therefre, are at risk f expsure t varius types f hazards, including chemical, bilgical, physical and radilgical. Hwever, with prudent practices, apprpriate equipment, prper facilities and awareness, all peratins can be handled safely, withut undue risk t KSU s emplyees, students, prperties r the envirnment. The respnsibility f ensuring a safe wrk envirnment at KSU is a shared respnsibility between emplyees, administratrs and EHS persnnel. Nevertheless, supervisrs, principal investigatrs (PIs) and managers have the primary respnsibility fr safety in wrk areas under their supervisin, and fr ensuring cmpliance with the applicable health, safety and envirnmental regulatins and plicies in these areas. The KSU Expsure Cntrl Plan (ECP) is established in accrdance with the OSHA Bldbrne Pathgens Standard (29 CFR ), and is prvided t all faculty, staff, emplyees, and students in an effrt t minimize r eliminate the ptential fr expsure t bldbrne pathgens (BBPs) in the wrk and r learning envirnment This ECP includes the fllwing elements: Emplyee expsure determinatin Expsure cntrl methds Universal Precautins Engineering cntrls Wrk practice cntrls Persnal Prtective Equipment (PPE) Husekeeping Vaccinatin recmmendatins (Hepatitis B) Pst-Expsure evaluatin and fllw-up Training Recrd keeping Incident Reprting The PIs and labratry supervisrs/managers shuld supplement the ECP with task-specific instructins and guidance regarding specific practices and prcedures unique t the wrk being dne, where ptential fr expsure t bld-brne pathgen exist. This Prgram will be reviewed at least annually, and whenever it is deemed necessary based n changes in prcedures and practices that directly affect emplyee expsure.

2 EOSMS-215 Date: REV: 1.0 PAGE: 2 OF 29 Cntact Infrmatin Envirnmental Health & Safety (EHS) Tel: (470) Fax: (470) ehs.kennesaw.edu Web: Bisafety Officer (BSO) Rdrick Esaw, (470) Institutinal Bisafety Cmmittee (IBC) Infrmatin n bldbrne pathgens and ther infectius agents; Bihazard infrmatin; Labratry spills r accidents invlving bihazards r chemicals; Bilgical safety cabinets; Recmbinant DNA guidelines; Chemical hygiene plan Hazardus waste dispsal (chemical, txic, animal); Shipping Requirements; Ventilatin (HVAC) prblems; Fume hd peratin; Labratry safety design Radiactive materials Research animal use Bldbrne pathgens training and infrmatin Public Safety, Security and Emergency Management (KSU Plice) resaw@kennesaw.edu Dr. Charles Amlaner VP f Research Tel: camlaner@kennesaw.edu Web: Rdrick Esaw, Labratry Safety Manager and Bisafety Officer (470) Vanessa Biggers Chemical Safety Manager Tel: (470) vbigger1@kennesaw.edu Plant Operatins/HVAC Shp Tel: (470) Web: web.kennesaw.edu/plantps/ EHS Office (470) Dr. Jared Taglialatela, Chair, Institutinal Animal Care and Use Cmmittee (IACUC) Tel: (470) jtaglia@kennesaw.edu Web: Rdrick Esaw, Labratry Safety Manager and Bisafety Officer (470) Public Safety Department Emergency: (470) N-Emergency: (470) *Fr the mst current cntact infrmatin, access the EHS website at EOSMS-215 Expsure Cntrl Plan Page 2

3 EOSMS-215 Date: REV: 1.0 PAGE: 3 OF 29 TABLE OF CONTENTS SCOPE AND APPLICATION... 4 ROLES AND RESPONSIBILITIES... 4 EMPLOYEE EXPOSURE DETERMINATION... 8 METHODS OF IMPLEMENTATION AND CONTROL ADDITIONAL METHODS OF IMPLEMENTATION AND CONTROL CLINICAL, RESEARCH, AND TEACHING LABORATORIES MEDICAL WASTE AND DECONTAMINATION PROCEDURES MEDICAL SURVEILLANCE INFORMATION AND TRAINING EMERGENCY PROCECURES RECORD KEEPING EOSMS-215 Expsure Cntrl Plan Page 3

4 EOSMS-215 Date: REV: 1.0 PAGE: 4 OF 29 SCOPE AND APPLICATION 1) Purpse The purpse f the Expsure Cntrl Prgram (ECP) is t utline the regulatry requirements and effective cntrl measures t minimize ptential fr expsure t BBPs, including but nt limited t Hepatitis B (HBV), Hepatitis C (HCV), and Human Immundeficiency Virus (HIV). The infrmatin prvided is based n the Occupatinal Health and Safety Administratin (OSHA) Bldbrne Pathgen (BBP) Standard (29 CFR ), and the best practices utlined by the Center fr Disease Cntrl s (CDC) - Bisafety in Medical and Bimedical Labratries, 5th Editin (BMBL). 2) Scpe The ECP applies t activities in all facilities wned, leased r perated by KSU, where KSU emplyees and students have the ptential t be expsed t BBPs while perfrming their wrk duties r in their learning envirnment. The expsure determinatin in Sectin 3 highlight the varius jb classificatins that are cvered under this ECP based n their ptential fr expsure t human bld, human bld cmpnents, BBPs, r ther ptentially infectius materials (OPIM). ROLES AND RESPONSIBILITIES 1) The University KSU has an bligatin t prvide a wrkplace fr its emplyees that is reasnably safe frm all recgnized hazards assciated with their jb duties, including bilgical hazards that culd cause illness in expsed individuals. Therefre, KSU has instituted the ECP fr all persnnel wh may be expsed t BBPs during the perfrmance f their duties. Under the ECP, the University has the fllwing respnsibilities: Ensuring apprpriate training is prvided t persnnel wh have the ptential t be expsed t BBPs while perfrming their jb duties. Prviding apprpriate persnal prtective equipment (PPE) fr emplyees. Making available t all affected emplyees the necessary vaccinatins (specifically, the Hepatitis B vaccine) at n cst, and t btain a declinatin frm frm all individuals wh decline t receive the vaccine. Establishing and implementing plicies fr safe cnduct during research activities invlving wrk with materials f human rigin and BBPs. Prviding adequately designed facilities and cntainment devices fr wrk with bilgical agents. Establishing and maintaining a health surveillance prgram fr persnnel. Reprting any significant prblems, vilatins, r significant research-related accidents r illnesses t the NIH Office f Bitechnlgy Activities (OBA) within 30 days. EOSMS-215 Expsure Cntrl Plan Page 4

5 EOSMS-215 Date: REV: 1.0 PAGE: 5 OF 29 2) Deans Creating visin, enfrce plicy, set perfrmance expectatins, and ensure timely availability f resurces that supprt the ECP. Prviding leadership t ensure effective implementatin f the ECP and ensure the Cllege s cmpliance with gverning laws, regulatins, and plicies. T this end, Deans may designate a safety fficer(s) within the Cllege/Schl. Reviewing labratry and safety-related assessment reprts as a means t assess and direct actins necessary t cntinually imprve safety at the Cllege/Schl. 3) Department/Schl Chairpersns Setting perfrmance expectatins, managing bisafety risks, and ensuring the Department s cmpliance with this prgram and ther Envirnmental and Occupatinal Safety (EOS) gverning laws, regulatin and plicies. Effectively implementing KSU s ECP and its requirements within their respective units and labratries. As apprpriate, incrprating the ECP requirements and respnsibilities int emplyee jb descriptins and addressing perfrmance related t the same. Ensuring that individuals under their supervisin, including but nt limited t supervisrs, regular and temprary emplyees, cntractrs, and ther affected persnnel, btain required BBP training. Develping a prcess t maintain incident/illness preventin and envirnmental prtectin prgrams within the department. Ensuring prmpt reprting and apprpriate investigatins f incidents/accidents within the unit, in accrdance with the University s Incident Reprting and Investigatin requirements (EOSMS- 108). Ensuring develpment and implementatin f a prcess fr cnducting hazard/risk assessments within their respective unit r labratry inclusive f peridic safety inspectins f wrk areas and/r facilities and ensuring nn-cmpliance items are crrected with fllw-up and clsure. Ensuring assessment f the envirnmental and ccupatinal safety impact f BBPs, prcesses and equipment, and incrprating apprpriate cntrls. 4) Envirnmental Health & Safety (EHS)/Bisafety Officer (BSO) The respnsibilities f EHS and the BSO include, but are nt limited t, the fllwing: Develping, implementing, and maintaining the university s ECP. Develping prtcls and prcedures t address expsure cncerns. Prviding training in the safe use and practices fr thse wrking with BBPs, materials f human rigin, and OPIM. EOSMS-215 Expsure Cntrl Plan Page 5

6 EOSMS-215 Date: REV: 1.0 PAGE: 6 OF 29 Prviding technical advice t PIs, supervisrs, the Institutinal Animal Care and Use Cmmittee (IACUC), and Institutinal Bisafety Cmmittee (IBC) n research safety prcedures. Cnsulting with researchers n issues f animal care, bisafety, and the safe use f bilgical materials in the labratry. Perfrming peridic inspectins t ensure that standard perating prcedures are being fllwed and regulatry requirements are being met. Prviding guidance t researchers n labratry security. Prviding guidance t researchers n prper waste dispsal methds in accrdance with federal and state regulatins. Assisting in the develpment f emergency plans fr handling accidental spills and persnnel cntaminatin. Investigating accidents invlving BBPs, materials f human rigin, and OPIM. 5) Institutinal Bisafety Cmmittee (IBC) Under the KSU ECP, the respnsibilities f the IBC are as fllws: Prviding guidance and supprt in the develpment f plicies and prcedures established fr activities invlving BBPs, materials f human rigin, and OPIM. Ensuring that all plicies, practices and facilities meet regulatry, state, and University requirements. Reviewing and apprving risk assessments. Reviewing research prpsals invlving BBPs, materials f human rigin, and OPIM. Based n risk assessment and review f research prpsals, apprving r disapprving prpsals based n level f risk. 6) Principal Investigatrs (PIs) PIs are respnsible fr cnducting diagnstic and/r research activities in a manner which minimizes the risk in the labratry envirnment. These respnsibilities include, but are nt limited t: Obtaining the required apprval frm the IBC fr new research prpsals as well as amended existing prpsals (i.e. additin f new agents, animals, etc.) prir t the cmmencement f such wrk with BBPs, materials f human rigin, and OPIM. Cmpleting and dcumenting risk assessments cnducted fr the purpse f determining level f risk and/r lwering the level f risk. Ensuring that lab emplyees and supprt persnnel wh will wrk with these materials are: (prir t wrking in the labratry): EOSMS-215 Expsure Cntrl Plan Page 6

7 EOSMS-215 Date: REV: 1.0 PAGE: 7 OF 29 Prperly trained and shw prficiency in standard micrbilgical practices at the apprpriate bisafety level(s) Aware f bihazards and precautins t be taken in cnducting research activities Advised f the nature recgnized and ptential hazards Infrmed f the indicatrs f accidental infectins Establishing standard perating prcedures (SOPs) fr labratry wrk. In cllabratin with the BSO, ensuring that the apprpriate immunizatins, serlgic mnitring, pst expsure prphylaxis, and ther medical mnitring are prvided t persnnel. In cllabratin with EHS and the BSO, develping prcedures fr dealing with accidental spills and accidental expsures amng persnnel. Reprting t the BSO and/r EHS issues pertaining t: All accidents/incidents within the lab that may pse a risk Expsure f persnnel t BBPs, materials f human rigin, and OPIM Cmprmise f bilgical r physical barriers Majr equipment failure which culd cmprmise safe peratins in the labratry In cnjunctin with the BSO, crrecting prcedures, which may result in hazardus incidents r emplyee expsures 7) Labratry Managers/Labratry Supervisrs (LMs/LSs) LMs/LSs shall supervise the day-t-day peratins lab. Their respnsibilities include but are nt limited t: Overseeing the activities f labratry emplyees and students engaged in research invlving BBPs, materials f human rigin, and OPIM. In cllabratin with the PI and BSO, ensuring that new staff and/r visiting scientists (e.g. vlunteer wrkers, high schl students, etc.) are prperly trained fr their assigned tasks. Ensuring that lab persnnel demnstrate prficiency in standard and special micrbilgical practices befre beginning wrk. Training emplyees and students n the SOPs in the lab. In cnjunctin with the BSO, ensuring that physical cntainment systems, supprt equipment, waste dispsal and peratin meet the safety guidelines. Perfrming regular checks/assessments f cntainment devices, equipment, and PPE. Ntifying the BSO and/r EHS f any incident r prblem that cmprmises the safety f the staff r the integrity f the lab. EOSMS-215 Expsure Cntrl Plan Page 7

8 EOSMS-215 Date: REV: 1.0 PAGE: 8 OF 29 8) Department Managers/Supervisrs (DMs/DSs) DMs and DSs shall supervise the day-t-day f the wrk area. Their respnsibilities include but are nt limited t: Overseeing the activities f emplyees and students engaged in activities where expsure t materials f human rigin and OPIM is pssible. Ensuring that new staff are prperly trained fr their assigned tasks. Ensuring that all peratins meet the safety guidelines. Perfrming regular checks/assessments f cntainment devices, equipment, and PPE. Ntifying the BSO and/r EHS f any incidents and/r issues that cmprmise the safety f the staff r the wrk area. 9) Emplyees All KSU emplyees have a right t be prtected against ptential expsure t wrkplace hazards, but als have a shared respnsibility fr ensuring their wn safety while perfrming their jb duties. Respnsibilities fr all emplyees under this ECP include, but are nt limited t: Cmpleting BBP Awareness training, departmental training, and any ther jb specific training ffered in a specific wrk area. Cnducting all activities in accrdance with the University s plicies, prcedures and guidelines, including the standards in this ECP. Familiarizing themselves with the SOPs and ptential hazards assciated with their wrk, and emergency prcedures. Emplying gd husekeeping practices t help maintain the wrk area in gd cnditin. Cmpleting all medical surveillance requirements. Reprting any medical restrictins, reprtable illnesses, and any event that may be the result f an expsure t the PI and Lab Manager/Supervisr. Reprting irregular wrkplace cnditins r accidents t the PI and EHS immediately. EMPLOYEE EXPOSURE DETERMINATION This ECP applies t all KSU emplyees and students wh have the ptential t be expsed t human bld r OPIM while perfrming their wrk duties. In accrdance with 29 CFR , an emplyee expsure determinatin has been made. The fllwing is a list f all jb classificatins at KSU in which all emplyees have ccupatinal expsure. EOSMS-215 Expsure Cntrl Plan Page 8

9 EOSMS-215 Date: REV: 1.0 PAGE: 9 OF 29 NOTE: These individuals are a part f the WellStar Health System, and therefre are nt cvered under the KSU ECP. Jb Title Department Lcatin Physicians, Nurse Practitiners Clinical Nursing Staff- RN, LPNs, CMAs WellStar Student Health Services WellStar Student Health Services Kennesaw and Marietta Campus Kennesaw and Marietta Campus The fllwing is a list f all jb classificatins in which sme emplyees at KSU have ccupatinal expsure. Included are anticipated tasks and/r prcedures by which ccupatinal expsure may ccur fr these individuals: Jb Title Department (s) Task/Prcedure Principal Investigatr/Faculty Mlecular/Cellular Bilgy Chemistry and Bichemistry Eclgy, Evlutin, Behavir, & Organismal Bilgy (EEOB) Research and r manipulatins invlving materials f human rigin, including bld, cells, tissues, DNA, BBPs, and etc. Principal Investigatr/Faculty Principal Investigatr/Faculty Labratry Crdinatrs Psychlgy Nursing Exercise and Sprts Management All Departments in Cllege f Science and Math Research and r manipulatins invlving materials f human rigin, including bld, cells, tissues, DNA, BBPs, and etc. Research and r manipulatins invlving materials f human rigin, including bld, cells, tissues, DNA, BBPs, and etc. Research and r manipulatins invlving materials f human rigin, including bld, cells, tissues, DNA, BBPs, and etc. EOSMS-215 Expsure Cntrl Plan Page 9

10 EOSMS-215 Date: REV: 1.0 PAGE: 10 OF 29 Labratry Persnnel (managers, technicians, grad students, TAs, etc.) Mlecular/Cellular Bilgy Chemistry and Bichemistry Eclgy, Evlutin, Behavir, & Organismal Bilgy (EEOB) Research and r manipulatins invlving materials f human rigin, including bld, cells, tissues, DNA, BBPs, and etc. Registered Nurses Nursing Research and r manipulatins invlving materials f human rigin, including bld, cells, tissues, DNA, BBPs, and etc. Labratry Persnnel (managers, technicians, clinical students, TAs, etc.) Labratry Persnnel (managers, technicians, grad students, TAs, etc.) Registered Nurses Labratry Persnnel (instructrs, technicians, etc.) Nursing Exercise and Sprts Management Cntinuing Educatin (Phlebtmy Prgram, Healthcare Assistance Prgram) Cntinuing Educatin (Phlebtmy Prgram, Healthcare Assistance Prgram) Research and r manipulatins invlving materials f human rigin, including bld, cells, tissues, DNA, BBPs, and etc. Research and r manipulatins invlving materials f human rigin, including bld, cells, tissues, DNA, BBPs, and etc. Bld draws, manipulatins invlving materials f human rigin, including bld, cells, tissues, DNA, BBPs, and etc. Bld draws, manipulatins invlving materials f human rigin, including bld, cells, tissues, DNA, BBPs, and etc. Bisafety Officer Department f EHS Bihazard spill respnse, labratry inspectins, etc. Chemical Safety Officer Chemical Safety Crdinatr Department f EHS Handling and string packages f medical waste Fire Safety Officer Department f EHS Assisting with r administering first aid KSU Plice Department f Public Safety Assisting with r administering first aid Athletic Trainers NCAA Sprts and Recreatin Intramural Sprts Assisting with r administering first aid, r treatment f athletic injuries EOSMS-215 Expsure Cntrl Plan Page 10

11 EOSMS-215 Date: REV: 1.0 PAGE: 11 OF 29 Custdial/Building Services Staff Department f Plant Operatins Cleaning f labratry, clinical, r residential areas where human bld r OPIM may be fund METHODS OF IMPLEMENTATION AND CONTROL 1) Universal Precautins All persnnel wh have the ptential t be expsed t BBPs shall bserve Universal Precautins. Under Universal Precautins, all human bld, tissues, cells, cell lines, DNA, and OPIM are treated as if they are knwn t be infected with BBPs (e.g.- HIV, HBV, HCV, etc.). OPIM refers t ther human bdily fluids including but nt limited t cerebrspinal fluid, vaginal secretins, semen, and pleural fluid. Therefre, the apprpriate administrative cntrls, engineering cntrls, wrk practices and PPE shuld be used t eliminate r minimize ptential expsure t all agents that are suspected t be infected with BBPs. Nte: Saliva, nasal secretins, sweat, tears, urine, emesis, and feces are nt assumed t be cntaminated with BBPs unless the bld is visible. In circumstances where is it difficult t tell, universal precautins apply. 2) General Wrk Practices In additin t Universal Precautins, which is an apprach t infectin cntrl, the fllwing general wrk practices must be bserved and fllwed by all emplyees wh have the ptential t be expsed t BBPs, materials f human rigin, r OPIM. Any specific hazards that are nt addressed in the fllwing wrk practices must be addressed by the develpment f department specific standard perating prcedures (SOPs). Only emplyees wh have been trained shall clean up surfaces cntaminated with human bld r OPIM. When decntaminating surfaces, use an apprpriate disinfectant slutin (e.g. 10 % bleach, r anther EPA apprved disinfectant). When decntaminating surfaces cntaminated with human bld r BBP, ensure that these prcedures are perfrmed in a manner as t minimize the frmatin f aersls, splashes, and sprays. Always wear the apprpriate PPE fr the task being perfrmed (e.g. glves, prtective clthing, safety gggles/glasses, she cvers, etc.) If breaks in the skin, such as cuts, laceratins, r dermatitis are present, additinal barriers f prtectin such as water prf bandages shuld be wrn under PPE until the cnditin is reslved. EOSMS-215 Expsure Cntrl Plan Page 11

12 EOSMS-215 Date: REV: 1.0 PAGE: 12 OF 29 After cmpleting decntaminatin/clean-up prcedures, discard all waste materials, including the PPE used as bihazard waste. Never reach int areas where yu cannt see. D nt cmpress waste in a garbage can by hand. Never pick up brken glass r sharp bjects with yur hands, but use a brm/dustpan, tngs, respectively. Reusable cntainers (e.g. garbage cans) which have a ptential fr becming cntaminated with BBPs r OPIM shall be inspected, cleaned, and decntaminated immediately after use, r as sn as pssible upn visible cntaminatin. Decntaminatin f reusable cntainers must be perfrmed in a manner t minimize expsure t BBPs r OPIM. If there is a risk fr percutaneus injury t emplyees, reusable cntainers must nt be pened, emptied, r cleaned manually r in any ther manner. D nt eat, drink, smke, r apply csmetics in wrk areas. Never stre fd, drinks, cntainers meant fr fd and drinks, r eating utensils in areas where chemicals r ptentially infectius agents are stred Always wash yur hands with warm water and sap after handling materials cntaminated with human bld r OPIM, even after remving glves. In the event that a sink with sap and warm water is nt immediately available, it is acceptable t use hand sanitizer r antiseptic twels until it is pssible t wash at a sink. 3) Persnal Prtective Equipment (PPE) All emplyees wh are anticipated t have ccupatinal expsure t infectius agents shall be prvided adequate PPE, which must be wrn while perfrming duties where expsure t these infectius agents is pssible. This PPE shall include, at minimum, glves and eye prtectin with side shields. Other frms f PPE will include splash gggles, face shields, and prtective clthing such as lab cats, gwns, and aprns. Apprpriate PPE will be prvided by the emplyer (at n cst t emplyees), and will be selected based n the task(s) being perfrmed. The emplyer shall ensure that the apprpriate PPE is readily available in the wrk area in a variety f sizes in rder t prperly utfit emplyees. The PPE will be cnsidered apprpriate nly if it prevents human bld r OPIM frm reaching the emplyee s clthing, skin, eyes, muth, r mucus membranes under nrmal cnditin, and fr the entire time that it is wrn. The wearing f PPE by emplyees will be enfrced by the respnsible party (PI, Supervisr, etc.) in their respective wrk areas. Nte: PPE requirements will vary depending n the wrk area, the type f wrk being perfrmed, r the anticipated expsure. EOSMS-215 Expsure Cntrl Plan Page 12

13 EOSMS-215 Date: REV: 1.0 PAGE: 13 OF 29 PPE must be remved prir t leaving the wrk area t prevent pssible cntaminatin f ther areas. Dispsable PPE that has been cntaminated with human bld r OPIM must be discarded as bihazard waste. Reusable PPE must be decntaminated after use. a. Glves Glves must be wrn by emplyees fr hand prtectin against infectius materials. Glves must be wrn when perfrming the fllwing duties: Handling r wrking with human bld r OPIM Handling r wrking with materials r n surfaces that may be ptentially cntaminated with human bld r OPIM When decntaminating surfaces r equipment that may be cntaminated with human bld r OPIM Other cnsideratins fr wearing glves are as fllws: Dispsable glves shall nt be used when visibly cntaminated, trn, r the integrity is therwise cmprmised. Dispsable glves shall nt be washed r decntaminated fr reuse. Cnsideratins must be made fr individuals with latex allergies, and alternatives t latex glves must be prvided. b. Prtective Clthing Prtective clthing must be wrn when there is ptential fr cntaminatin f emplyees clthing r expsed skin by infectius materials. Lab cats, aprns, r dispsable gwns shall be wrn when there is ptential fr grss cntaminatin f emplyees persns r clthing, r when there is the likelihd f the generatin f aersls r splashes f human bld r OPIM. When apprpriate, head cvers, she cvers, and/r rubber bts shall be wrn. Prtective clthing shall be remved prir t leaving the wrk area. Dispsable prtective clthing shall be discarded as bihazard waste. Reusable, cntaminated prtective clthing shall be laundered by a KSU apprved vendr prir t reuse. Prtective clthing must nt be laundered at a dry cleaning service r in emplyees hmes. c. Eye and Face Prtectin Eye and face prtectin shall be wrn when there is ptential fr expsure t the eyes, muth, r ther mucus membranes thrugh aersls r splashes f human bld r OPIM. EOSMS-215 Expsure Cntrl Plan Page 13

14 EOSMS-215 Date: REV: 1.0 PAGE: 14 OF 29 At minimum, safety glasses with side shields shall be wrn when wrking with infectius materials. Splash prf gggles shall be wrn when there is ptential fr expsure t the eyes thrugh generatin f splashes and/r aersls. Surgical masks and/r face shields shall be wrn in additin t eye prtectin when it is reasnably anticipated that an expsure culd ccur thrugh splashes, sprays, aersls, drplets, r splattering f human bld r OPIM. 4) Husekeeping All emplyees wh have the ptential t be expsed t BBPs, OPIM, r any ther infectius agents while perfrming wrk duties must adhere t the fllwing general husekeeping requirements: All wrk surfaces and equipment that have the ptential t be cntaminated with infectius agents must be cleaned and disinfected regularly. Wrk surfaces where infectius agents will be used shuld be layered with a prtective cvering, such as bench paper r ther absrbent materials t facilitate decntaminatin. After wrk with infectius agents has been cmpleted, wrk surfaces and equipment shall be cntaminated immediately afterwards. Items which are intended fr regular use with infectius agents (e.g. waste receptacles, bins, etc.) must be decntaminated regularly, and immediately when visible cntaminatin is present. All spills f infectius agents must be cleaned immediately using an apprpriate disinfectant (e.g. 10% bleach slutin, 70% ethanl, r ther EPA apprved disinfectants). Individuals wh decntaminate wrk surfaces and/r equipment cntaminated with infectius agents shall wear the apprpriate PPE (i.e. eye prtectin, glves, lab cat/aprn, lab apprpriate attire, and clsed te shes.) ADDITIONAL METHODS OF IMPLEMENTATION AND CONTROL IN CLINICAL, RESEARCH, AND TEACHING LABORATORIES In additin t bserving universal precautins and fllwing general wrk practices, mre specific methds f implementatin and cntrl are required in labratry settings where expsure t BBPs and OPIM are anticipated. The fllwing cntrls and wrk practices must be in place fr the prtectin f persnnel wh wrk in research, clinical, r teaching labratries. Any specific hazards that are nt addressed in the fllwing wrk practices must be addressed by the develpment f department specific SOPs. EOSMS-215 Expsure Cntrl Plan Page 14

15 EOSMS-215 Date: REV: 1.0 PAGE: 15 OF 29 1) Engineering Cntrls Effective engineering cntrls must be emplyed t minimize r cmpletely eliminate the ptential fr expsure t BBPs and materials infected with them. Engineering cntrls are designed t prevent emplyee expsure t wrkplace hazards by either remving the hazard frm the wrker r limiting emplyee access t the hazard. If engineering cntrls are prven t be ineffective r are nt available, a hazard assessment will be cnducted by EHS determine what cntrls are necessary, and that they are implemented accrdingly. Under ECP, the fllwing engineering cntrls must be used t minimize emplyee expsure t BBPs: c.a. Hand Washing Facilities Hand washing facilities are available fr individuals wh have the ptential t be expsed t BBPs Sinks are lcated in labratries, restrms, and ther lcatins n KSU s campus. Each hand washing facility must be maintained with running water, sap, and paper twels. In the event that an area is nt equipped with a sink r installatin is nt feasible, hand sanitizer r antiseptic twels must be prvided as a temprary slutin (i.e. expsed individuals shuld lcate the nearest sink and wash with sap and water as sn as pssible). d.b. Sharps Cntainers During the use and dispsal f sharp bjects r tls, such as syringes, scalpels, razr blades, r Pasteur pipettes, great care must be taken t prevent injury r expsure. When used with materials ptentially infected with BBPs, the ptential exists fr expsure thrugh puncture wunds, cuts, and laceratins. Therefre, when wrking with sharps, sharps cntainers must be made available, and must meet the fllwing criteria: Psitined as clse t the pint f use/dispsal as feasible Puncture resistant, leak prf, clsable when nt in use, and labeled with the universal bihazard symbl Must remain upright during use Must nt be verfilled (i.e. shuld nly be filled ¾ full) e.c. Emergency Eyewash Statins Emergency eyewash statins must be made available in areas where there is a ptential fr eye expsure t hazardus agents. Eyewash statins are available in labratry areas near sinks r in EOSMS-215 Expsure Cntrl Plan Page 15

16 EOSMS-215 Date: REV: 1.0 PAGE: 16 OF 29 hallways ften cupled with emergency shwers. Emergency eyewash statins must meet the fllwing criteria: Duble cular s that bth eyes can be rinsed simultaneusly Hands-free peratin Dust caps must be kept in place when nt in use t prevent the settling f dust n the eye pieces (replacement caps can be rdered if nt available) Eyewash statins must be free f bstructins Eyewash statins at the sinks must be tested weekly; thse cupled with emergency shwers must be tested mnthly. Each test must be dcumented (signature f tester and the date f the test). f.d. Bilgical Safety Cabinets (BSCs) Labratry wrk that culd result in the creating f aersls, drplets, splashes, and/r spills f infectius materials (including BBPs) must be cnducted inside f a cntainment device such as a BSC (Class I r Class II). Using these materials n a benchtp r laminar flw hd withut prper cntainment may increase the likelihd f an expsure. Bisafety cabinets must meet the fllwing criteria: Bisafety cabinets must be certified annually. Frnt grills must be free f bstructins t allw adequate ventilatin. The use f Bunsen burners inside a BSC is prhibited. BSCs must be decntaminated after use. Fr mre infrmatin n the prper use and maintenance f BSCs, refer t Appendix A f the BMBL. All wrk in labratries invlving human bld, OPIM, r BBPs must be cnducted at Bisafety Level 2 (BSL-2), as defined by the Centers fr Disease Cntrl and Preventin (CDC) in the Bisafety in Micrbilgical and Bimedical Labratries publicatin. Fr wrk invlving the drawing f bld using syringes, see the sectin n the Use f Sharps belw. All wrk with human bld, OPIM, r BBPs must be perfrmed in a manner as t minimize the frmatin f aersls, splashes, and sprays. Standard micrbilgical practices must be emplyed. Engineering cntrls such as BSCs must be used as cntainment devices t minimize the ptential fr expsure. EOSMS-215 Expsure Cntrl Plan Page 16

17 EOSMS-215 Date: REV: 1.0 PAGE: 17 OF 29 2) Labratry Wrk Practice Cntrls a. General Labratry Wrk Practices Muth pipetting is prhibited. Eating, drinking, smking, and the applicatin f csmetics is prhibited in all labratry areas. Strage f fd, drinks, cntainers meant fr fd and drinks, r eating utensils in refrigeratrs r areas where chemicals r ptentially infectius agents is prhibited. Individuals must wear the apprpriate lab attire and persnal prtective equipment (PPE) (clsed te shes, lng pants, lab cat, task apprpriate glves, and eye prtectin with side shield prtectin) t prvide an additinal barrier f prtectin when wrking with infectius materials, including BBPs. All hazard signs and pstings must be bserved. b. Use f Sharps Avid the use f sharps (e.g. needles, syringes, razr blades, scalpels, etc.) where pssible. When sharps must be used, they must nt be recapped, bent, sheared, r discarded in regular trash. After use, sharps must be immediately discarded int a hard-walled sharps cntainer that is clsable and is prperly labeled with the universal bihazard symbl. Where pssible, needleless devices and safety devices (e.g. retractable needles) shuld be used t reduce expsure ptential t BBPs and OPIM. Never reach int a sharps cntainer t retrieve used sharps. c. Reusable Cntainers Reusable cntainers which have a ptential fr becming cntaminated with BBPs r OPIM shall be inspected, cleaned, and decntaminated immediately after use, r as sn as pssible upn visible cntaminatin. Decntaminatin f reusable cntainers must be perfrmed in a manner t minimize expsure t BBPs r OPIM. If there is a risk fr percutaneus injury t emplyees, reusable cntainers must nt be pened, emptied, r cleaned manually r in any ther manner. d. Bilgical Samples and Specimens EOSMS-215 Expsure Cntrl Plan Page 17

18 EOSMS-215 Date: REV: 1.0 PAGE: 18 OF 29 As prescribed by the CDC and NIH in the BMBL, all prcessing r analyses f human bld, OPIM, r ther infectius agents shuld be cnducted under BSL-2 cntainment. Any prcedure invlving the use f human bld, OPIM, r ther infectius agents shuld be perfrmed in a manner that minimizes splashing, aerslizatin, and/r spraying f these materials. Human materials such as cell lines and DNA must be treated as OPIM, unless apprpriate screening has been cnducted and the materials have been certified as free f BBPs. When wrking with any such materials, standard micrbilgical wrk practices must be used t minimize the spread f cntaminatin and ptential infectin. All samples f bld r OPIM must be placed in a cntainer that prevents leaking during cllectin, handling, prcessing, strage, transprt, r shipping. The cntainer must be labeled with the standard bihazard symbl and clsed prir t being stred, transprted, r shipped. When samples are being transprted, primary cntainers (vials, cllectin tubes, etc.) must be packed int a secndary cntainer. Secndary cntainers must als be labeled with the standard bihazard symbl. If it is pssible fr the primary cntainer t puncture the secndary cntainer, then the secndary cntainer must be puncture resistant. Nte: Only KSU emplyees wh have received the apprpriate Department f Transprtatin (DOT)/Internatinal Air Transprt Assciatin (IATA) training are authrized t ship infectius agents r hazardus materials. DOT and IATA training is currently ffered by EHS. If assistance is needed fr shipping f specimens, cntact EHS. 3) Labratry Equipment a. Centrifuge Use Centrifuges are cmmnly used in labratries as a means f separating materials accrding t size and density. If used inapprpriately, they can cause expsure t hazardus materials, including bld brne pathgens and OPIM. Cnsider the fllwing when using centrifuges with infectius materials: Fllw the apprpriate SOPs fr centrifuge use. Ensure that all tubes fr use in the centrifuge are cmpatible. When lading samples, use centrifuge safety caps r sealed rtrs t prevent spills. D nt attempt t perate the centrifuge while the dr/lid is pen. Befre remving samples (particularly thse that are infectius r ptentially infectius), wait 10 minutes befre pening the centrifuge t allw any aersls prduced t settle. Always wear apprpriate PPE when lading and remving samples frm the centrifuge. EOSMS-215 Expsure Cntrl Plan Page 18

19 EOSMS-215 Date: REV: 1.0 PAGE: 19 OF 29 Decntaminate all spills immediately using an apprpriate disinfectant. b. Autclave Use Autclaves and sterilizers use steam, extreme heat (smetimes in excess f 250 degrees Fahrenheit), and pressure as a means f decntaminating and/r sterilizing materials, including but nt limited t metal instruments, liquids, and infectius waste materials. Cnsider the fllwing when perating autclaves/sterilizers: Anyne wh will be authrized t use an autclave must first be trained n its peratin. Prir t using an autclave, any remaining items shuld be remved. When using the autclave t deactivate infectius waste, ensure that the unit is validated using the spre test methd. This ensures that the unit reaches the necessary temperature t deactivate pathgens. Autclaves shuld never be verladed. Fllw the apprpriate SOP fr perating the autclave. Wear apprpriate PPE when remving materials frm the autclave (e.g. lng thermal glves, lab cat, eye prtectin, clsed te shes), as nt ding s will result in severe burns. If handling sharp instruments that have been autclaved, use cut resistant glves t prevent inadvertent incisins r laceratins. Never attempt t pen an autclave while it is in peratin. Autclaves are pressurized vessels, and ding s culd result in the release f steam, the ejectin f the cmpnents r cntents f the autclave, and the sudden release f the autclave dr, all which culd result in the severe injury r death f an individual. Preventative maintenance must be perfrmed n autclave units peridically t prevent mechanical failure. Maintenance must be cnducted accrding t the manufacturer s specificatins, and by an individual trained in recgnizing critical defects that culd result in a mechanical failure. A maintenance histry shuld be kept t indicate all inspectins, failures, and repairs. MEDICAL WASTE AND DECONTAMINATION PROCEDURES 1) Bilgical/Infectius Waste Bimedical/infectius waste, accrding t Gergia Rule , includes pathlgical waste, bld and bld prducts, cultures and stcks f infectius agents, cntaminated animal carcasses, cntaminated sharps, chemtherapy waste, and discarded medical equipment and parts. These materials must be handled and dispsed f as fllws: EOSMS-215 Expsure Cntrl Plan Page 19

20 EOSMS-215 Date: REV: 1.0 PAGE: 20 OF 29 Bimedical/infectius waste must be cllected in cntainers that are prperly labeled (bihazard symbl with the wrd Bihazard ), clseable, and leak prf. Cntainers must remain clsed unless waste is being added t prevent leaking r spillage. In the event that the waste cntainer becmes cntaminated, it must be placed in a secndary cntainer that is als clsable, leak prf, and labeled apprpriately. Must be segregated frm all ther waste materials at the pint f rigin. Liquid bimedical waste, including bld and bld prducts, exudates, secretins, suctinings, and ther bdy fluids must nt be discarded dwn the drain. Slid bimedical waste must nt be discarded in the general waste stream. Cntaminated sharps must be cntained in leak prf, rigid, puncture resistant cntainers which are tightly lidded r taped clsed t prevent spilling f cntents during strage, transprtatin, treatment, and/r dispsal. All bimedical/infectius waste must be decntaminated prir t dispsal (autclaving, chemical deactivatin, etc.), r shipped by EHS t be incinerated thrugh an apprpriate vendr. Fr mre guidance n the handling f bimedical/infectius waste, reference Gergia Rule ) Prtectin f Vacuum Lines Tissue culture wrk in labratries generates liquid wastes that must nt be discarded prir t treatment. Usually, vacuum systems are used t aspirate these wastes. Accrding t the recmmendatins f the Centers fr Disease Cntrl (CDC) and the Natinal Institutes f Health (NIH), the vacuum lines f these systems shuld be prtected as fllws: Vacuum lines shuld be equipped with High Efficiency Particulate Air (HEPA) filters and liquid disinfectant traps t cntaminatin f the exhaust system r aerslized pathgens. The filters must be checked regularly and replaced as necessary. The HEPA filter, installed inline, will islate and cnfine infectius materials and prevent aersl cntaminatin f the vacuum pumps. This update prvides prper disinfectin and dispsal prcedures fr tissue culture wastes. EOSMS-215 Expsure Cntrl Plan Page 20

21 EOSMS-215 Date: REV: 1.0 PAGE: 21 OF 29 3) Chemical Decntaminatin Wrk surfaces, reusable cntainers, and equipment used with human bld, OPIM, and ther infectius agents must be decntaminated regularly t prevent the spread f cntaminatin and infectin. Certain chemicals can be used in the deactivatin f infectius materials. Apprpriate disinfectants such as bleach and ther EPA registered disinfectants can be used fr decntaminatin purpses. Husehld bleach (5% sdium hypchlrite) can be diluted t a 10% slutin (1/10) with water, which is sufficient fr the deactivatin f BBPs. Husehld bleach lses its effectiveness ver time; therefre it is imprtant t make fresh 1/10 bleach slutins at least mnthly ensure effective decntaminatin f surfaces. Preparing a fresh 1/10 slutin is recmmended t be used in the event f a spill f bihazardus materials. Nte: There are varius EPA registered disinfectants that are effective against the mst cmmn pathgens. 4) Lab Attire and Laundry Lab cats r ther prtective attire such as gwns r aprns must be wrn when wrking in labratry areas where human bld, OPIM, and ther infectius agents are manipulated/prcessed. Cntaminated labratry attire must be handled as fllws: Dispsable lab cats r ther prtective attire such as surgical masks, head cvers, she cvers, etc., that becme cntaminated with human bld, OPIM, r ther infectius agents, must be dispsed f as regulated medical waste. Lab cats cntaminated with human bld, OPIM, r ther infectius agents must be placed in an apprpriate cntainer (e.g. laundry bag, clthes hamper, etc.) labeled with the standard bihazard symbl (flurescent range r red with cntrasting clrs fr symbls and print). Cntaminated lab cats shall be picked up, laundered, and returned by a vendr apprved by the University. Cntaminated lab cats, unifrms, r ther prtective attire must nt be laundered at a dry cleaning business r in emplyees hmes. EOSMS-215 Expsure Cntrl Plan Page 21

22 EOSMS-215 Date: REV: 1.0 PAGE: 22 OF 29 MEDICAL SURVEILLANCE 1) Vaccinatins Emplyees with ptential fr expsure t BBPs and/r OPIM will be affrded the pprtunity t receive Hepatitis B vaccinatin. The fllwing accmmdatins shall be made in accrdance with OSHA 29 CFR : The Hepatitis B vaccinatin will be ffered t each emplyee with ptential ccupatinal expsure, unless ne f the fllwing cnditins exists: The emplyee has previusly had the full series f the vaccinatin and dcumentatin can be prvided t cnfirm The emplyee cannt be administered the vaccinatin fr medical reasns The emplyee has been tested fr antibdies and immunity is cnfirmed In the event that an emplyee declines the vaccinatin fr any reasn, s/he must sign a written statement cnfirming her/his declinatin. In the event that an emplyee wh has ptential wrkplace expsure initially declines t have Hepatitis B vaccine, but later decides t accept the vaccinatin, the vaccinatin shall be made available at that time. 2) Pst Expsure Evaluatin and Fllw-Up The fllwing accmmdatins shall be prvided fr any emplyee after s/he has reprted an ccupatinal expsure t human bld, r OPIM: KSU will prvide each expsed emplyee the pprtunity t have a cnfidential medical evaluatin and fllw-up cnsultatin which shall include, but nt be limited t the fllwing elements: The dcumentatin f the rutes f expsure and the circumstances under which the expsure incident ccurred Identificatin and dcumentatin f the surce individual, unless KSU can establish that identificatin is nt pssible, r is prhibited by state r lcal law After cnsent has been given by the surce individual, his/her bld shall be tested as sn as pssible t determine HBV and HIV infectivity. If cnsent cannt be btained, KSU shall establish that EOSMS-215 Expsure Cntrl Plan Page 22

23 EOSMS-215 Date: REV: 1.0 PAGE: 23 OF 29 legally required cnsent cannt be btained. When the surce individual s cnsent is nt required by law, his/her bld, if available, shall be tested and the results shall be dcumented. If the surce individual is already knwn t be infected with HBV r HIV, then testing f his/her bld will nt be required. The results f the surce individual s tests shall be made available t the expsed individual, and he/she shall be infrmed f the applicable laws and regulatins cncerning disclsure f the identity and infectius state f the surce individual. A sample f bld frm the expsed individual will be cllected as sn as pssible after btaining cnsent. Pst-expsure prphylaxis, when medically indicated, will be prvided as recmmended by the United States Public Health Service (USPHS). Cunseling shall be made available regarding reductin f risk and the risks and benefits f HIV testing in accrdance with state law. KSU will prvide a cpy f this ECP t the health care prfessinal respnsible fr the Hepatitis B vaccinatin. The health care prfessinal wh evaluates persnnel after an expsure will be prvided with the fllwing: A descriptin f the expsed emplyee s jb respnsibilities as they relate t the expsure event Dcumentatin f the rutes f expsure and the circumstances under which the event ccurred The results f the surce individuals bld tests (if available), and All medical recrds relevant t the apprpriate treatment f the emplyee, including vaccinatin status, maintained by KSU. Fr each expsure evaluatin, KSU shall btain and prvide expsed individuals with a cpy f the evaluating health care prfessinal's written pinin within 15 wrking days. The written pinin will be limited t the fllwing infrmatin: Healthcare prfessinals written pinins shall be as fllws: EOSMS-215 Expsure Cntrl Plan Page 23

24 EOSMS-215 Date: REV: 1.0 PAGE: 24 OF 29 Regarding Hepatitis B vaccinatin, whether vaccinatin is indicated fr an emplyee, and if the emplyee has received the vaccinatin Fr pst expsure evaluatin and fllw-up, statements must include that the expsed emplyee has been infrmed f the results f the evaluatin, and abut any medical cnditin(s) that remain as a result f expsure t human bld r OPIM that require further evaluatin r treatment. All ther infrmatin shall be kept cnfidential, and nt included in the statement, but will be available t the emplyee and/r his representative in accrdance with HIPAA laws. INFORMATION AND TRAINING 1) Training All emplyees wh have the ptential fr ccupatinal expsure t BBPs and OPIM shall participate in the BBPs Training Prgram established by KSU, and shall be trained in accrdance with OSHA 29 CFR Training shall be prvided fr each qualifying emplyee as fllws: Training will be prvided at the time f initial assignment f jb duties that have the ptential fr expsure t human bld and OPIM. Refresher training is required at least annually, and must be prvided within ne year after initial training. Additinal training shall be prvided as a result f mdificatins t wrk practices and/r additin f new wrk practices that may affect emplyees expsure ptential. Individuals wh administer training n BBPs must be knwledgeable in all cntent presented in the training prgram as well as hw it relates t the wrkplace envirnment Training administratrs must allw all persnnel attending the training curse t ask interactive questins n the subject matter Training may be prvided using the fllwing methds: Persnal instructin (classrm mdel) Cmputer based training (nline mdel) Training manuals Thrugh media surces such as vides r newsletter articles published by EHS EOSMS-215 Expsure Cntrl Plan Page 24

25 EOSMS-215 Date: REV: 1.0 PAGE: 25 OF 29 2) Additinal Training Requirements Fr sme wrk envirnments, such as clinical labratries r research labratries where persnnel wrk with human bld, OPIM, r BBPs, additinal labratry specific training is required. The PI r Labratry Supervisr must ensure that all persnnel wh have ccupatinal expsure ptential have prir experience wrking with human pathgens r tissue cultures. Persnnel must demnstrate prficiency in standard micrbilgical practices befre wrking with HIV r HBV. The emplyee must nt participate in wrk invlving infectius agents until prficiency is demnstrated. A training prgram must be prvided t emplyees wh have n prir experience in handling human pathgens. Initial wrk activities must nt include the handling f infectius agents. A prgressin f wrk activities must be assigned as techniques are learned and prficiency is develped. The emplyer must assure that emplyees participate in wrk activities invlving infectius agents nly after prficiency has been demnstrated. 3) Signage and Pstings All wrk areas where bilgical agents are used r stred must be psted with the apprpriate hazard/warning labels. These areas include, but are nt limited t, research labratries, teaching labratries, clinical labratries, animal facilities, HIV/HBV Research and Prductin facilities (29 CFR ), autclave rms, and bimedical waste strage areas. The fllwing criteria must be met fr the hazard/warning labels: Labels must be mstly flurescent range r red with symbls and lettering in cntrasting clr (usually black). The universal bihazard symbl must be present. Bihazard warning labels must be affixed t the fllwing: Cntainers f infectius waste (infectius waste that has been decntaminated is exempt frm this requirement) Equipment used t manipulate r prcess infectius materials (e.g. centrifuges, BSCs, incubatrs, etc.) Equipment used t stre infectius materials (e.g. refrigeratrs, freezers, etc.), Cntainers used t transprt human bld, OPIM, and/r ther infectius materials Laundry bags used fr cllecting cntaminated lab cats r ther prtective clthing. EOSMS-215 Expsure Cntrl Plan Page 25

26 EOSMS-215 Date: REV: 1.0 PAGE: 26 OF 29 Nte: Cntainers f bld, bld cmpnents, r bld prducts that are labeled as t their cntents and have been released fr transfusin r ther clinical use are exempted frm the labeling requirements. Individual cntainers f human bld r OPIM that are placed in labeled cntainers during strage, transprt, shipment, r dispsal are als exempt. Bihazard warning labels must be affixed t cntainers in a way that prevents lss r unintentinal remval, either by adhesive, string, wire, r any ther successful methd. Access drs t areas where human bld, OPIM, and ther infectius agents are used under bisafety cntainment must be labeled with the standard bihazard symbl and the apprpriate Bisafety designatin (BSL1, BSL2, etc.) EMERGENCY PROCECURES In the event f an emergency invlving BBPs r OPIM, remember that persnal safety is paramunt. Immediate emergency respnse may reduce the ptential fr human expsure and/r disease. 1) Expsure t BBPs r OPIM When any emplyee is expsed t human bld, BBPs r OPIM, the fllwing steps must be taken: Immediately wash the affected area Fr cular expsures, g t the nearest emergency eyewash statin, activate the eyewash, hld pen the eyelids, and wash the eyes fr a minimum f 15 minutes. Fr percutaneus expsures such as needle sticks, cuts, laceratins, r ther pen wunds, g t the nearest sink and wash the affected area with sap and warm water fr a minimum f 15 minutes. If necessary, call r have smene call the KSU emergency number (KSU Plice) at (ext. 6666) r 911 fr emergency help, clearly stating the nature f the incident and the lcatin where it has ccurred. After immediate care has been administered, the expsed individual shuld fllw up with a medical prfessinal fr pst expsure fllw-up. 2) Spill Prcedures The fllwing prcedures must be fllwed fr all spills invlving human bld, BBPs, r OPIM: All spills must be immediately cntained and cleaned by trained emplyees. Universal precautins must be bserved. The apprpriate PPE must be wrn when cleaning spills (i.e. glves, eye prtectin, prtective clthing, etc.) All surfaces cntaminated with infectius materials must be decntaminated using an apprpriate disinfectant (e.g. 10 % bleach, 70 % ethanl, r ther EPA apprved disinfectants). EOSMS-215 Expsure Cntrl Plan Page 26