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Federal Register /Vol. 56, No. 235 i Friday, December 6, 1991 /Rule and Regulations 64177
<br />(B) The employer shall ensure that
<br />this information is conveyed to all
<br />affected employees, the servicing
<br />representative, and/or the manufacturer,
<br />as appropriate, prior to handling;
<br />servicing, or shipping so that
<br />appropriate precautions will be taken.
<br />(3) Personal protective equipment—(i)
<br />Provision. When there is occupational
<br />exposure, the employer shall provide, at
<br />no cost to the employee, appropriate
<br />personal protective equipment such as,
<br />but not limited to, gloves, gowns,
<br />laboratory coats, face shields or masks
<br />and eye protection, and mouthpieces,
<br />resuscitation bags, pocket masks, or
<br />other ventilation devices. Personal
<br />protective equipment will be considered
<br />.,appropriate" only if it does not permit
<br />blood or other potentially infectious
<br />materials to pass through to or reach the
<br />employee's work clothes, street clothes.
<br />undergarments, skin, eyes, mouth, or
<br />other mucous membranes under normal
<br />conditions of use and for the duration of
<br />time which the protective equipment
<br />will be used.
<br />(ii) Use, The employer shall ensure
<br />that the employee uses appropriate
<br />personal protective equipment unless
<br />the employer shows that the employee
<br />temporarily and briefly declined to use
<br />personal protective equipment when,
<br />under rare and extraordinary
<br />circumstances, it was the employee's
<br />professional judgment that in the
<br />specific instance its use would have
<br />prevented the delivery of health care or
<br />public safety services or would have
<br />posed an increased hazard to the safety
<br />of the worker or co-worker. When the
<br />employee makes this judgement, the
<br />circumstances shall be investigated and
<br />documented in order to determine
<br />whether changes can be instituted to
<br />prevent such occurences in the future.
<br />(iii) Accessibility. The employer shall
<br />ensure that appropriate personal
<br />protective equipment in the appropriate
<br />sizes is readily accessible at the
<br />worksite or is issued to employees.
<br />Hypoallergenic gloves, glove liners,
<br />powderless gloves, or other similar
<br />alternatives shall be readily accessible
<br />to those employees who are allergic to
<br />the gloves normally provided.
<br />(iv) Cleaning, Laundering, and
<br />Disposal. The employer shall clean,
<br />launder, and dispose of personal
<br />protective equipment required by
<br />paragraphs (d) and (e) of this standard,
<br />at no cost to the employee.
<br />(v) Repair and Replacement. The
<br />employer shall repair or replace
<br />personal protective equipment as
<br />needed to maintain its effectiveness, at
<br />no cost to the employee.
<br />(vi) If a garment(s) is penetrated by
<br />blood or other potentially infectious
<br />materials, the garment(s) shall be
<br />removed immediately or as soon as
<br />feasible.
<br />(vii) All personal protective
<br />equipment shall be removed prior to
<br />leaving the work area.
<br />(viii) When personal protective
<br />equipment is removed it shall be placed
<br />in an appropriately designated area or
<br />container for storage, washing,
<br />decontamination or disposal.
<br />(ix) Gloves. Gloves shall be worn
<br />when it can be reasonably anticipated
<br />that the employee may have hand
<br />contact with blood, other potentially
<br />infectious materials, mucous
<br />membranes, and non -intact skin; when
<br />performing vascular access procedures
<br />except as specified in paragraph
<br />(d)(3)(ix)(D); and when handling or
<br />touching contaminated items or
<br />surfaces.
<br />(A) Disposable (single use) gloves
<br />such as surgical or examination gloves,
<br />shall be replaced as soon as practical
<br />when contaminated or as soon as
<br />feasible if they are torn, punctured, or
<br />when their ability to function as a
<br />barrier is compromised.
<br />(B) Disposable (single use) gloves
<br />shall not be washed or decontaminated
<br />for re -use.
<br />(C) Utility gloves may be
<br />decontaminated for re -use if the
<br />integrity of the glove is not
<br />compromised. However, they must be
<br />discarded if they are cracked, peeling,
<br />torn, punctured, or exhibit other signs of
<br />deterioration or when their ability to
<br />function as a barrier is compromised.
<br />(D) If an employer in a volunteer
<br />blood donation center judges that
<br />routine gloving for all phlebotomies is
<br />not necessary then the employer shall:
<br />(1) Periodically reevaluate this policy;
<br />(2) Make gloves available to all
<br />employees who wish to use them for
<br />phlebotomy;
<br />(3) Not discourage the use of gloves
<br />for phlebotomy; and
<br />(4) Require that gloves be used for
<br />phlebotomy in the following
<br />circumstances:
<br />(1) When the employee has cuts,
<br />scratches, or other breaks in his or her
<br />skin;
<br />(ii) When the employee judges that
<br />hand contamination with blood may
<br />occur, for example, when performing
<br />phlebotomy on an uncooperative source
<br />individual; and
<br />(iii) When the employee is receiving
<br />training in phlebotomy.
<br />(x) Masks, Eye Protection, and Face
<br />Shields. Masks in combination with eye
<br />protection devices, such as goggles or
<br />glasses with solid side shields, or chin -
<br />length face shields, shall be worn
<br />whenever splashes, spray, spatter, or
<br />droplets of blood or other potentially
<br />infectious materials may be generated
<br />and eye, nose, or mouth contamination
<br />can be reasonably anticipated.
<br />(xi) Gowns, Aprons, and Other
<br />Protective Body Clothing. Appropriate
<br />protective clothing such as, but not
<br />limited to, gowns, aprons, lab coots,
<br />clinic jackets, or similar outer garments
<br />shall be worn in occupational exposure
<br />situations. The type and characteristics
<br />will depend upon the task and degree of
<br />exposure anticipated.
<br />(xii) Surgical caps or hoods and/or
<br />shoe covers or boots shall be worn in
<br />instances when gross contamination can
<br />reasonably be anticipated (e.g.,
<br />autopsies, orthopaedic surgery).
<br />(4) Housekeeping. (i) General.
<br />Employers shall ensure that the worksite
<br />is maintained in a clean and sanitary
<br />condition. The employer shall determine
<br />and implement an appropriate written
<br />schedule for cleaning and method of
<br />decontamination based upon the
<br />location within the facility, type of
<br />surface to be cleaned, type of soil
<br />present, and tasks or procedures being
<br />performed in the area.
<br />(ii) All equipment and environmental
<br />and working surfaces shall be cleaned
<br />and decontaminated after contact with
<br />blood or other potentially infectious
<br />materials.
<br />(A) Contaminated work surfaces shall
<br />be decontaminated with an appropriate
<br />disinfectant after completion of
<br />procedures; immediately or as soon as
<br />feasible when surfaces are overtly
<br />contaminated or after any spill of blood
<br />or other potentially infectious materials;
<br />and at the end of the work shift if the
<br />surface may have become contaminated
<br />since the last cleaning.
<br />(B) Protective coverings, such as
<br />plastic wrap, aluminum foil, or
<br />imperviously -backed absorbent paper
<br />used to cover equipment and
<br />environmental surfaces, shall be
<br />removed and replaced as soon as
<br />feasible when they become overtly
<br />contaminated or at the end of the
<br />workshift if they may have become
<br />contaminated during the shift.
<br />(C) All bins, pails, cans, and similar
<br />receptacles intended for reuse which
<br />have a reasonable likelihood for
<br />becoming contaminated with blood or
<br />other potentially infectious materials
<br />shall be inspected and decontaminated
<br />on a regularly scheduled basis and
<br />cleaned and decontaminated
<br />immediately or as soon as feasible upon
<br />visible contamination.
<br />(D) Broken glassware which may be
<br />contaminated shall not bq picked up
<br />directly with the hands. It shall be
<br />cleaned up using mechanical means,
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