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Federal Register / V%0, No. 235 / Friday, December 6, 199 es and Regulations <br />after consent is obtained in order to <br />determine HBV and HIV infectivity. If <br />consent is not obtained, the employer <br />shall establish that legally required <br />consent cannot be obtained. When the <br />source individual's consent is not <br />required by law, the source individual's <br />blood, if available, shall be tested and <br />the results documented. <br />(B) When the source individual is <br />already known to be infected with HBV <br />or HIV, testing for the source <br />individual's known HBV or HIV status <br />need not be repeated. <br />(C) Results of the source individual's <br />testing shall be made available to the <br />exposed employee, and the employee <br />shall be informed of applicable laws and <br />regulations concerning disclosure of the <br />identity and infectious status of the <br />source individual. <br />(iii) Collection and testing of blood for <br />HBV and HIV serological status; <br />(A) The exposed employee's blood <br />shall be collected as soon as feasible <br />and tested after consent is obtained. <br />(B) If the employee consents to <br />baseline blood collection, but does not <br />give consent at that time for HIV <br />serologic testing, the sample shall be <br />preserved for at least 90 days. If, within <br />90 days of the exposure incident, the <br />employee elects to have the baseline <br />sample tested, such testing shall be done <br />as soon as feasible. <br />(iv) Post -exposure prophylaxis, when <br />medically indicated, as recommended <br />by the U.S. Public Health Service; <br />(v) Counseling; and <br />(vi) Evaluation of reported illnesses. <br />(4) Information Provided to the <br />Healthcare Professional. (i) The <br />employer shall ensure that the <br />healthcare professional responsible for <br />the employee's Hepatitis B vaccination <br />is provided a copy of this regulation. <br />(ii) The employer shall ensure that the <br />healthcare professional evaluating an <br />employee after an exposure incident is <br />provided the following information: <br />(A) A copy of this regulation; <br />(B) A description of the exposed <br />employee's duties as they relate to the <br />exposure incident; <br />(C) Documentation of the route(s) of <br />exposure and circumstances under <br />which exposure occurred; <br />(D) Results of the source individual's <br />blood testing, if available; and <br />(E) All medical records relevant to the <br />appropriate treatment of the employee <br />including vaccination status which are <br />the employer's responsibility to <br />maintain. <br />(5) Healthcare Professional's Written <br />Opinion. The employer shall obtain and <br />provide the employee with a copy of the <br />evaluating healthcare professionals <br />written opinion within 15 days of the <br />completion of the evaluation. <br />(i) The healthcare professional's <br />written opinion for Hepatitis B <br />vaccination shall be limited to whether <br />Hepatitis B vaccination is indicated for <br />an employee, and if the employee has <br />received such vaccination. <br />(ii) The healthcare professional's <br />written opinion for post -exposure <br />evaluation and follow-up shall be <br />limited to the following information: <br />(A) That the employee has been <br />informed of the results of the evaluation; <br />and <br />(B) That the employee has been told <br />about any medical conditions resulting <br />from exposure to blood or other <br />potentially infectious materials which <br />require further evaluation or treatment. <br />(iii) All other findings or diagnoses shall <br />remain confidential and shall not be <br />included in the written report. <br />(6) Medical recordkeeping. Medical <br />records required by this standard shall <br />be maintained in accordance with <br />paragraph (h)(1) of this section. <br />(g) Communication of hazards to <br />employees— (1) Labels and signs. (i) <br />Labels. (A) Warning labels shall be <br />affixed to containers of regulated waste, <br />refrigerators and freezers containing <br />blood or other potentially infectious <br />material; and other containers used to <br />store, transport or ship blood or other <br />potentially infectious materials, except <br />as provided in paragraph (g)(1)(i)(E), (F) <br />and (G). <br />(B) Labels required by this section <br />shall include the following legend: <br />In <br />BIOHAZARD <br />(C) These labels shall be fluorescent <br />orange or orange -red or predominantly <br />so, with lettering or symbols in a <br />contrasting color. <br />(D) Labels required by affixed as <br />close as feasible to the container by <br />string, wire, adhesive, or other method <br />that prevents their loss or unintentional <br />removal. <br />(E) Red bags or red containers may be <br />substituted for labels. <br />(F) Containers of blood blood <br />components, or blood products that are <br />labeled as to their contents and have <br />been released for transfusion or other <br />clinical use are exempted from fhe <br />labeling requirements of paragraph (g). <br />(G) Individual containers of blood or <br />other potentially infectious materials <br />that are placed in a labeled container <br />during storage, transport, shipment or <br />disposal are exempted from the labeling <br />requirement. <br />(H) Labels required for contaminated <br />equipment shall be in accordance with <br />this paragraph and shall also state <br />which portions of the equipment remain <br />contaminated. <br />(I) Regulated waste that has been <br />decontaminated need not be labeled or <br />color -coded. <br />(ii) Signs. (A) The employer shall post <br />signs at the entrance to work areas <br />specified in paragraph (e), HIV and HBV <br />Research Laboratory and Production <br />Facilities, which shall bear the following <br />legend: <br />BIOHAZARD <br />(Name of the Infectious Agent) <br />(Special requirements for entering the area) <br />(Name, telephone number of the laboratory <br />director or other responsible person.) <br />(B) These signs shall be fluorescent <br />orange -red or predominantly so. with <br />lettering or symbols in a contrasting <br />color. <br />(2) Information and Training. (i) <br />Employers shall ensure that all <br />employees with occupational exposure <br />participate in a training program which <br />must be provided at no'cost to the <br />employee and during working hours. <br />(ii) Training shall be provided as <br />follows: <br />(A) At the time of initial assignment to <br />tasks where occupational exposure may <br />take place; <br />(B) Within 90 days after the effective <br />date of the standard; and <br />(C) At least annually thereafter. <br />(iii) For employees who have received <br />training on bloodborne pathogens in the <br />year preceding the effective date of the <br />standard, only training with respect to <br />the provisions of the standard which <br />were not included need be provided. <br />(iv) Annual training foi all employees <br />shall be provided within one year of <br />their previous training. <br />