Exposure Control Plan

This exposure plan is adopted to meet the requirements for bloodborne pathogen exposure control at Mansfield Independent School District. 25 TAC 96; Health & Safety Code §81.301-81.306; 29 Code of Federal Regulation §1910.1030, OSHA 8loodborne Pathogens Standard; 088 Legal A copy of this plan shall be accessible to all employees, parents and volunteers via: a) Campus Health Clinics b) District Departments c) Mansfield ISO intranet Individual departments and campuses will be responsible for ensuring that the provisions of the district's exposure control plan and the mandates of the Texas Department of State Health Services (DSHS) bloodborne pathogen standard are carried out. The OSHA standards define bloodborne pathogens as pathogenic microorganisms that are present in human blood and can infect and cause diseases in persons who are exposed to blood containing the pathogens. These pathogens include, but are not limited to the hepatitis B virus (HBV) and the human immunodeficiency virus (HIV) which causes acquired immune deficiency syndrome (AIDS).

Precautions Apply To:	Body Fluids Not Requiring Universal Precautions Unless Visible Blood is Present:
Blood Tissues Amniotic fluid Pericardial fluid Synovial fluid Cerebrospinal fluid Semen Vaginal Secretions Any body fluid visibly contaminated with blood	Feces Nasal Secretions Sputum Sweat Breast milk Urine Vomitus Saliva

Occupational exposure to bloodborne pathogens may occur through: 

• Non-intact skin
• Mucous membranes such as mouth or eyes
• Puncture or penetration of the skin
• Inhalation

Exposure Determination 
The Texas Department of State Health Services Bloodborne Pathogens Exposure Control Plan requires employers to perform an exposure determination for employees who have occupational exposure to blood or other potentially infectious materials. This exposure determination is made without regard to the use of personal protective equipment. The exposure determination is required to list all job classifications in which employees have occupational exposure, regardless of frequency. The following MISD job classifications apply: 

a) Middle and High School Principals and Assistant Principals
b) Nurses and Clinic Aides
c) Custodians
d) Trainers
e) Identified Special Education Personnel
f) Identified Bus Personnel

The job descriptions for the above employees encompass the potential occupational exposure risks to bloodborne pathogens. 

Engineering and Work Practice Controls 

• Engineering and work practice controls are important in eliminating or minimizing employee exposure to bloodborne pathogens, and reduce employee exposure in the workplace by either removing or isolating the hazard/worker from exposure. Engineering and work practice controls shall be examined and maintained or replaced on a regular schedule to ensure their effectiveness. Where occupational exposure remains after institution of these controls, personal protective equipment (PPE) shall be used (gloves, goggles, gowns).

Universal Precautions 

• All employees will be instructed that all blood, body fluids or other potentially infectious materials are to be considered infectious regardless of the perceived status of the source individual.

Handwashing 

• Handwashing facilities will be readily accessible to all employees who have exposure to blood or other potentially infectious materials. 
  • Handwashing facilities are available to employees who incur exposure to blood or potentially infectious materials. 
  • All employees will wash their hands and any other potentially contaminated skin area with soap and water immediately after removing PPE, such as gloves. 
  • Employees incurring exposure to their skin or mucous membranes will wash with soap and water or flush with water as soon feasible following contact. 
  • Waterless hand sanitizer when proper handwashing facilities are not available. Hands should be washed with soap and running water as soon as feasible.

Needles/Sharps 

• Contaminated sharps and needles will be discarded immediately or as soon as feasible in district-provided sharps containers that are closable, puncture resistant, leak-proof on sides and bottom, and properly labeled as a biohazard. Sharps containers: 
  • Will be readily available and easily accessible to all staff and students where sharps are being used; 
  • Will be located as close as is feasible to the immediate area where sharps are being used or can be reasonable anticipated to be found; 
  • Are maintained upright throughout use; 
  • Are properly labeled with a Biohazard label 
  • Are not allowed to overfill; and 
  • Are replaced routinely. 

Contaminated needles and sharps will not be bent, recapped, removed, sheared, or purposely broken. An exception may be made to recapping needles by the use of a one-handed technique in situations where proper disposal is not feasible. 

Work Area Restrictions 

• All procedures will be conducted in a manner to minimize splashing, spraying, splattering and generation of droplets of blood or other potentially infectious materials. 
• Food and beverages are not to be kept in refrigerators, cabinets, or countertops where blood or other potentially infectious materials are present.

Contaminated Equipment 

• Equipment which may become contaminated with blood or other potentially infectious materials will be examined prior to use and decontaminated as necessary. If unable to decontaminate, the item will be labeled and biohazard and disposed of as appropriate.

Personal Protective Equipment 

• Gloves will be worn where it is reasonably anticipated that employees will have hand contact with blood or other potentially infectious materials, non-intact skin, and mucous membranes. Synthetic gloves will be provided for employees who are latex sensitive.
• Gloves will be available in each classroom and sent on field trips with a first aid kit. Disposable gloves are not to be washed or decontaminated for re-use, and are to be replaced as soon as practical when they become contaminated, cracked, peeling, torn or when their ability to function as a barrier is compromised.
• All PPE will be disposed of by MISD in an appropriate manner. PPE that has been penetrated by blood should be removed immediately or as soon as feasible and placed in double plastic bags, tied, and discarded in an appropriate manner. 

Housekeeping 

• Worksites will be maintained in a clean and sanitary condition. A written cleaning schedule for all campuses will be determined and implemented by the Director of Maintenance, and will include methods for decontamination, types of surfaces to be cleaned and types of cleaners/disinfectant products and methods to be used.
• All work surfaces will be decontaminated after completion of procedures immediately or as soon as feasible after they have become contaminated with blood or other potentially infectious body fluids.
• All waste receptacles will be inspected and decontaminated a regularly scheduled basis. Any broken glassware which may be contaminated will not be picked up directly with the hands.

Regulated Waste Disposal 

• All contaminated sharps waste will be disposed of in accordance with federal, state, county and local requirements. Contaminated items such as PPE, bandages and other non-sharp materials will be double bagged and tied, labeled biohazard, and disposed of in accordance with federal, state, county and local requirements.

Hepatitis B Vaccine 

• All employees who have been identified as having occupational exposure to blood or other potentially infectious materials will be offered the hepatitis B vaccine, at no cost to the employee, under the supervision of a licensed physician or licensed healthcare professional. The vaccine is offered after Bloodborne pathogens training and within 10 days of their initial assignment to work unless the employee has previously received the complete hepatitis B vaccination series, antibody testing has revealed that the employee is immune, or that the vaccine is contraindicated for medical reasons.
• Contact Risk Management, your Department/Campus Administrator or School Nurse to arrange for the vaccine series. Employees who decline the Hepatitis B vaccine sign a declination statement, which will be kept in the employee's file. Employees who initially decline the vaccine but who later elect to receive it may then have the vaccine provided at no cost. 

• Immediately wash exposed area with soap and water
• If exposed area involved is your mouth, rinse your mouth thoroughly with water, or if water is not available, rinse with mouthwash
• Eyes - flush with water thoroughly at least five (5) minutes
• Notify the school nurse of exposure or Health Services Coordinator. The nurse will:
  • Assist with first aid, as needed
  • Assess and document the route(s) of exposure and the circumstances related to the incident
  • Identification and documentation of the source individual unless the employer can establish that the identification is infeasible. After obtaining consent for source testing, the blood of the source individual should be tested for HIV/ HBV infectivity. Results of testing will be made available to the exposed employee or physician following all applicable laws and regulations concerning disclosure of the identity and infectivity of the source individual.

After first aid has been rendered, the following actions should be completed:

• Notify campus or department administrator 
• Complete a Workers' Compensation Form (See campus nurse or department secretary)
• Medical evaluation must be conducted as soon as possible after exposure in accordance with Mansfield ISO Workman's Compensation Medical Evaluation Procedures, which will include:
  • Employee being offered the option of having his/her blood collected for testing of their HIV/HBV serological status;
  • Employee will be offered post exposure prophylaxis in accordance with the current recommendations of the US Public Health Services
  • Appropriate counseling concerning infection status, results, and interpretation of tests, and precautions to take during the period after the exposure incident;
  • Employee will be informed about what potential illnesses can develop and to seek early medical evaluation and subsequent treatment.
  • The Health Service Director is designated to assure that the policy outlined here is effectively carried out and maintain records related to this policy.

* Students and volunteers will be referred to their physician/healthcare provider on the day of the incident for immediate care. The student's healthcare provider will provide post­exposure treatment and counseling. 

All medical evaluations and procedures, including the Hepatitis B vaccine and vaccination series and post-exposure follow-up will be: 

• Made available at no cost to the employee. Through a Worker's Compensation Provider. Expenses incurred shall be the responsibility of Mansfield ISO following the procedure of exhausting any available funding such as private insurance or Medicaid
• Made available at a reasonable time and place
• Performed by or under the supervision of a licensed physician
• Provided according to the recommendations of the U.S. Public Health Department
• Documented at the point of service provision
• All laboratory tests shall be conducted by an accredited facility
• Workers' Compensation claim will be turned over to MIS D's Third Party Administrator for review and determination if incident is compensable.
• Record of all sharps injuries will be reported to TDSHS
  www.dshs.texas.gov/idcu/health/infection control/bloodborne pathogens/reporting

Training of all employees is conducted prior to initial assignment to tasks where occupational exposure may occur. All employees also receive annual refresher training. Training for employees is conducted by a person knowledgeable in the subject matter and includes an explanation of the following: 

• OSHA Bloodborne Pathogen Final Rule
• Epidemiology and symptomatology of Bloodborne diseases;
• Modes of transmission of blood borne pathogens;
• Mansfield ISD's exposure control plan;
• Procedures which might cause exposure to blood or other potentially infectious materials at this facility;
• Control methods which are used at MISD to control exposure to blood or other potentially infectious materials;
• Personal protective equipment available at each facility;
• Hepatitis B vaccine program at the facility;
• Procedures to follow in an emergency involving blood or other potentially infectious materials;
• Procedures to follow if an exposure incident occurs, to include U.S. Public Health Service Post Exposure Prophylaxis Guidelines;
• Post exposure evaluation and follow up;
• Signs and labels used at the facility; and
• An opportunity to ask questions with the individual conducting the training and referral of questions to Administrator if needed

Mansfield ISD shall annually review the exposure control plan. The review shall include:

• A list of new task that affect occupational exposure;
  Modifications of task and procedures;
• A list of new employee positions with potential for occupational exposure
• Input from non-managerial employees responsible for direct patient care or classrooms training regarding practice controls.

Link to Signed Exposure Plan.pdf

Texas Department of State Health Services (2006, November 22). Bloodborne pathogen control in Texas schools. Retrieved November 13, 2009 from http://www.dshs.state.tx.us/schoolhealth/bldbrnpt.shtm

Texas Department of State Health Services. (n.d.) B/oodborne pathogens exposure control plan: Chapter 81, Health and Safety Code: Subchapter H. Retrieved November 15, 2009, from
http://www.dshs.state.tx.us/idcu/health/infection control/bloodborne pathogens/exposure_control/adopt_ecp/pdf

US Department of Labor Occupational Safety & Health Administration. (n.d.) Regulations (Standards - 29 CFR) Bloodborne pathogens 1910.1030. Retrieved November 13, 2009 from http://www.osha.gov/pls/oshaweb/owadisp.show document?p table=STANDARDS&p d=10051