Policy on the Protection of Employees Against the Hepatitis B Virus

1.0 Reference

Cal/OSHA Special Order, California Labor Code 6305, Federal OSHA-29CFR 1910.1030. Cal/OSHA Title 8, Section 5193 (proposed).

2.0 Background

Hepatitis B is a disease which causes inflammation of the liver. It is caused by the Hepatitis B Virus (HBV). It strikes about 200,000 persons in the United States each year. Hepatitis B is usually spread by contact with infected blood or blood products. It can also be spread in such ways as illicit injectable drug use, tattooing, and ear piercing. In addition to its presence in blood, the Hepatitis B virus may be found in other body fluids such as urine, tears, semen, vaginal secretions, and breast milk. As a result, transmission of the disease can also occur through close interpersonal contact, including sexual contact.

Exposure or potential exposure to HBV is defined in terms of actual or potential skin, mucous membrane, parenteral contract with blood, body fluids, and tissues. Tissues and body fluids are not only those materials from humans, but also potentially infectious fluids and tissues associated with laboratory investigations of HBV e.g., organs and excreta from experimental animals, embryonated eggs, tissue or cell cultures and culture media, etc.

At present there is no specific treatment or no known cure. Prevention is the only method of control. There is now an effective vaccine against Hepatitis B.

OSHA policy is that the employer must offer HBV vaccinations in advance of exposure to personnel who provide first aid at a first aid station, clinic or dispensary or health care, emergency response or University Police personnel expected to render first aid in the course of their work. Employers are permitted to offer the vaccine to certain first aid providers within 24 hours of possible exposure rather than before. This is limited to persons who render first aid only as a collateral duty, responding solely to injuries resulting from workplace incidents, generally at the location where the incident occurred.

3.0 Policy

It is the policy of California State University, Fullerton to ensure the safe and healthful working conditions of health care and other employees who may be exposed or have the potential of exposure to Hepatitis B Virus (HBV).

Employees covered under this policy are those at high or moderate risk of exposure as defined below. All other employees will be evaluated and determined on an individual basis by the Director of the Student Health Center.

High Risk

Procedures or other job related tasks that involve an inherent potential for mucous membrane or skin contact with blood, body fluids, or tissues or a potential for spills or splashes of these fluids.

Position Classifications

Physician
Radiological Technologist
Registered Nurse
Clinical Laboratory Tech
Nurse Practitioner
Clinical Aid
Radiation Safety Personnel

Moderate Risk

Normal work routine involves no exposure to blood, body fluids, or tissues; but exposure or potential exposure may be required as a condition of employment.

Position Classifications

Custodians (assigned to Health Center)
University Police Officer
Director of University Police
Supervising University Police Officer
University Police Investigator
Physical Therapist
Athletic Trainers
Student Athletic Trainers

C. Minimal Risk

The following job classifications may, depending on the nature of their job, come into contact with blood or blood products. It will the responsibility of the Director of the Student Health Center to make the determination whether or not persons in these job classifications should be included in the Hepatitis B vaccination program.

Equipment Technician (music)
Biohazard Waste Tech
Nursing Faculty
Animal Handlers
Wrestling Coaches

5.0 Responsibilities

5.1 Environmental Health and Safety Office

Schedules employees for the series of vaccinations. Funds the vaccinations from the University's Physical Exam budget. Keeps records of all those employees either on the program or offered the program.

5.2 Director of Student Health Center

Determines if those individuals not in the high or moderate risk categories should be included in the Hepatitis B vaccination program.

5.3 Supervising Athletic Trainer

Insures all student athletic trainers have been offered vaccination against HBV. Insures each student trainer has signed the waiver either accepting or refusing participation in this program.

5.4 Employees

Employees identified in the high or moderate risk categories are responsible for obtaining the vaccination as scheduled or signing a waiver form (see Attachment 1).

6.0 Program

In keeping with this policy, Hepatitis B vaccinations shall be offered free of charge to employees who are at substantial risk of directly contacting body fluids. Vaccinations shall be administered in amounts and at times prescribed by standard medical practice.

6.1 Determination of Program Participants

The Director of the Student Health Center and Director of Environmental Health and Safety, with consultation of the campus wide Occupational Safety and Health Committee, will determine those job classifications at the University that will be included in the HBV vaccination program.

6.2 Employee Notification

Employees within those job classifications will be notified by their supervisors about the program and allowed to decide if they wish to obtain the vaccination series. Employees may decline to receive the vaccination, however, a waiver must be signed in either case.

6.3 Scheduling of Vaccinations

Vaccinations will be conducted either by the Student Health Center or St. Jude Hospital, Industrial Medicine Clinic. Scheduling is dependent on the availability of the serum and the schedule of the employee. Since a booster must be done one month and six months after the initial vaccination, employees must be available at those times.

6.4 Student Athletic Trainers

Student Athletic Trainers begin their two year internship with the University during the month of August. At that time, supervisors of the trainers will schedule initial vaccinations at the Student Health Center for those accepting the series.

6.5 Verification of HBV Protection

Because the vaccination series is not always 100% effective in developing the anti-bodies necessary to protect the individual from the disease, a blood test and titer are necessary to determine protection. Titers should be checked 6 months following the last vaccination.

6.6 Record keeping

A copy of the waiver and schedule of vaccinations must be kept by both the Supervisor and the Environmental Health and Safety Office. These records must be maintained for thirty years past the last day of employment.