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Vol. 5 , o. 235 Friday. December 6. 1991 / .,a and Regulations 81 - Federal Register/ / Y (v) Employers shall provide additional training when changes such as modification of tasks or procedures or institution of new tasks or procedures affect the employee's occupational exposure. The additional training may be limited to addressing the new exposures created. (vi) Material appropriate in content and vocabulary to educational level. literacy, and language of employees shall be used. (vii) The training program shall contain at a minimum the following elements: (A) Anaccessible copy of the regulatory text of this standard and an explanation of its contents; (B) A general explanation of the epidemiology and symptoms of bloodborne diseases; (C) An explanation of the modes of transmission of bloodborne pathogens; (D) An explanation of the employer's exposure control plan and the means by which the employee can obtain a copy of the written plan; (E) An explanation of the appropriate methods for recognizing tasks and other activities that may involve exposure to blood and other potentially infectious materials; (F) An explanation of the use and limitations of methods that will prevent or reduce exposure including appropriate engineering controls, work practices, and personal protective equipment; (G) Information on the types, proper use, location, removal, handling, decontamination and disposal of personal protective equipment; (H) An explanation of the basis for selection of personal protective equipment; (I) Information on the hepatitis B vaccine, including information on its efficacy, safety, method of administration, the benefits of being vaccinated, and that the vaccine and vaccination will be offered free of charge; (1) Information on the appropriate actions to take and persons to contact in an emergency involving blood or other potentially infectious materials; (K) An explanation of the procedure to follow if an exposure incident occurs, including the method of reporting the incident and the medical follow-up that will be made available; (L) Information on the post -exposure evaluation and follow-up that the employer is required to provide for the employee following an exposure incident; (M) An explanation of the signs and labels and/or color coding required by paragraph (g)(1); and (N) An opportunity for interactive questions and answers with the person conducting the training session. (viii) The person conducting the training shall be knowledgeable in the subject matter covered by the elements contained in the training program as it relates to the workplace that the training will address. (ix) Additional Initial Training for Employees in HIV and HBV Laboratories and Production Facilities. Employees in HIV or HBV research laboratories and HIV or HBV production facilities shall receive the following initial training in addition to the above training requirements. (A) The employer shall assure that employees demonstrate proficiency in standard microbiological practices and techniques and in the practices and operations specific to the facility before being allowed to work with HIV or HBV. (B) The employer shall assure that employees have prior experience in the handling of human pathogens or tissue cultures before working with HIV or FIBV. (C) The employer shall provide a training program to employees who have no prior experience in handling human pathogens. Initial work activities shall not include the handling of infectious agents. A progression of work activities shall be assigned as techniques are learned and proficiency is developed. The employer shall assure that employees participate in work activities involving infectious agents only after proficiency has been demonstrated. (h) Recordkeeping—(1) Medical Records. (i) The employer shall establish and maintain an accurate record for each employee with occupational exposure, in accordance with 29 CFR 1910.20. (ii) This record shall include: (A) The name and social security number of the employee; (B) A copy of the employee's hepatitis B vaccination status including the dates of all the hepatitis B vaccinations and any medical records relative to the employee's ability to receive vaccination as required by paragraph (0(2): (C) A copy of all results of examinations, medical testing, and follow-up procedures as required by paragraph (f)(3); (D) The employer's copy of the healthcare professional's written opinion as required by paragraph (f)(5); and (E) A copy of the information provided to the healthcare professional as required by paragraphs (f)(4)(ii)(8)(C) and (D). (iii) Confidentiality. The employer shall ensure that employee medical records required by paragraph (h)(1) are: (A) Kept confidential: and (B) Are not disclosed or reported without the employee's express written consent to any person within or outside the workplace except as required by this section or as may be required by law. (iv) The employer shall maintain the, records required by paragraph (h) for at least the duration of employment plus 30 years in accordance with 29 CFR 1910.20. (2) Training Records. (i) Training records shall include the following information: (A) The dates of the training sessions; (B) The contents or a summary of the training sessions; (C) The names and qualifications of persons conducting the training; and (D) The names and job titles of all persons attending the training sessions. (ii) Training records shall be maintained for 3 years from the date on which the training occurred. (3) Availability. (i) The employer shall ensure that all records required to be maintained by this section shall be made available upon request to the Assistant Secretary and the Director for examination and copying. (ii) Employee training records required by this paragraph shall be provided upon request for examination and copying to employees, to employee representatives, to the Director, and to the Assistant Secretary in accordance with 29 CFR 1910.20. (iii) Employee medical records required by this paragraph shall be provided upon request for examination and copying to the subject employee, to anyone having written consent of the subject employee, to the Director, and to the Assistant Secretary in accordance with 29 CFR 1910.20. (4) Transfer of Records. (i) The employer shall comply with the requirements involving transfer of records set forth in 29 CFR 1910.20(h). (ii) If the employer ceases to do business and there is no successor employer to receive and retain the records for the prescribed period, the employer shall notify the Director, at least three months prior to their disposal and transmit them to the Director, if required by the Director to do so, within that three month period. (i) Dates—(1) Effective Date. The standard shall become effective on March 6. 1992. (2) The Exposure Control Plan required by paragraph (c)(2) of this section shall be completed on or before May 5,1992. 9_3