PROGRAM STATEMENT

The purpose of the Exposure Control Plan is to eliminate or minimize employee occupational exposure to blood or certain body fluids. This plan follows the requirements established and is developed from the rules issued by the U.S. Occupational Safety and Health Administration in December, 1991 (29 CFR 1910.1030).

Safety Committee
The TWU Safety Committee shall review and update the Exposure Control Plan routinely. Additional meetings will be conducted as deemed necessary by the Chairperson of the Committee or the Safety Coordinator.

The Committee shall be responsible for the following:
Review and update the Exposure Control Plan as new or modified tasks and procedures are developed which affect positions with possible occupational exposure.
Review the circumstances surrounding exposure incidents with the goal of identifying and correcting problems in order to prevent the recurrence of similar incidents.
Maintain written minutes of meetings in sufficient detail to document all pertinent proceedings.
Ensure that a copy of the Exposure Control plan is accessible to employees.
Assure that all components of the Exposure Control Plan are made available to the Texas Department of Health and State Office of Risk Management for examination and copying upon request.

TERMS AND DEFINITIONS
Blood Titer
For the purpose of this policy , the term "blood titer" refers to the evaluation of a sample of blood for the presence of Hepatitis B surface antibody.
Contaminated
The presence, or the reasonably anticipated presence, of blood or other potentially infectious materials on an item surface.
Contaminated Laundry
This means laundry that has been soiled with blood or other potentially infectious materials.
Texas Department of Health
The Texas agency that will enforce the Bloodborne Pathogens Rule for State agencies.
Texas Commision on Environmental Quality
The state agency that administers and enforces the state’s environmental protection and natural resource conservation statutes, regulations and programs. The TCEQ administers statutes and guidelines for infectious waste management, which are referenced in this policy.
Designated First Aid Provider
For the purpose of this policy, these are individuals who are required to provide first aid in emergency situations as a condition of their employment. These individuals may perform this function as a primary duty (e.g. life guard), or as a duty incidental to other duties (e.g. day care providers or community assistants).
Exposure Incident
As defined in 29 CFR 1901.1030(b), this means a specific eye, mouth, or other mucus membrane, non-intact skin, or parenteral contact with blood or other potentially infectious materials that results from the performance of an employee’s duties.
Other Potentially Infectious Materials (OPIM)
This means certain human body fluids: semen, vaginal secretions, cerebrospinal fluid, synovial fluid, pleural fluid, peritoneal fluid, amniotic fluid, saliva in dental procedures, and any body fluid that is visibly contaminated with blood, and all body fluids in situations where it’s difficult or impossible to differentiate between body fluids. It also includes any unfixed tissue or organ (other than intact skin) from a human (living or dead) and HIV-containing cell or tissue cultures, organ cultures, and HIV-or HBV-containing culture medium or other solutions, and blood, organs, or other tissues from experimental animals infected with HIV or HBV.
Occupational Safety and Health Administration (OSHA)
The federal agency that enforces Title 29 of the Code of Federal Regulations which includes the Bloodborne Pathogens Rule.
Serologic Status
For the purpose of this policy, the term used to describe the results of blood testing to determine whether and individual has measurable levels of the Hepatitis B Virus or the Human Immunodeficiency Virus. A "positive’ serologic status means the person has measurable blood levels of virus; a "negative" serologic status means the individual has not. A person who "sercoconverts", changes from a negative to a positive status.
Sharps and Contaminated Sharps
A "sharp" is any object that can readily penetrate the skin, including, but not limited to, broken glass, needles, scalpels, broken capillary tubes, and exposed ends of dental wires, for the purpose of this policy, the definition "contaminated sharps" is limited to those contaminated with blood or other potentially infectious materials.
Universal Precautions
This is an approach to infection control whereby all human blood and certain human body fluids are treated as if known to be infectious for HIV, HBV, and other bloodborne pathogens.

EXPOSURE DETERMINATION
Exposure Categories
OSHA has established three (3) exposure categories for protection against occupational exposure to infectious diseases including HBV and HIV infections.

These categories are as follows:
Category I
Tasks that involve exposure to human blood, body fluids, or tissues.
All procedures or other job-related tasks that involve an inherent potential for mucous membrane or skin contact with human blood, body fluids, or tissues, or a potential for spills or splashes of them are Category I tasks. Use of appropriate personal protective equipment will be required for every employee engaged in Category I tasks.
Category II
Tasks that involve no exposure to human blood, body fluids, or tissues but employment may require performing unplanned Category I tasks.
The normal work routine involves no exposure to blood, body fluids, or tissues, but exposure or potential exposure may occur as a condition of employment. Appropriate personal protective equipment will be readily available to every employee engaged in Category II tasks.
Category III
Tasks that involve no exposure to human blood, body fluids or tissues, and Category I tasks are not a condition of employment .
The normal work routine involves no exposure to human blood, body fluids or tissues (although situations may be imagined or hypothesized under which anyone, anywhere, might encounter potential exposure to body fluids). Persons who perform these duties are not called upon as part of their employment to perform or assist in emergency medical care or first aid or to be potentially exposed in some other way.

It is the policy of the Texas Woman’s University that certain employees be classified as either Category I, Category II, or Category III.

Category I job classifications shall include:
All medical doctors, dentists, dental hygienist, dental assistants, nurses, physician's assistants, medical lab technicians, nursing assistants, police officers, athletic trainers, lifeguards, and child care workers. Also included are researchers, instructors and student employees who work in laboratories or clinics where human blood and other potentially infectious materials are used, regardless of frequency.

Category II job classifications shall include:
Custodial staff, laundry workers, environmental health staff, pharmacists, plumbers, community assistants and security officers.

Category III job classifications shall include:
Auto mechanics, accountants, clerical staff, communications workers, computer operators, trade workers (except plumbers), electronics technicians, engineers, food service workers, graphic artists, grounds personnel, instrument makers,maintenance mechanics, motor vehicle operators, personnel services staff, warehouse personnel and power plant operators.

Category III tasks and procedures that may result in occupational exposure:
1. Disposing of soiled tissues or other debris soiled with visible blood from classrooms,laboratories, clinics, hallways or offices.
2. Physical contact with other employees, students or visitors with exudative lesions or weeping dermatitis.
3. Provision of emergency first aid or CPR until professional help arrives.

WRITTEN EXPOSURE CONTROL PLAN
To help to protect employees against exposure to human bloodborne pathogens, the following control steps will be undertaken:
First, "Universal Precautions" will be observed to prevent contact with blood or other potentially infectious materials.
Second, engineering and work practice controls will be followed to prevent contact with potentially infectious materials.
Third, specimens and equipment will be handled under strict guidelines. Finally, a hazard communication procedure will be followed to alert all employees to the possibility that pathogenic materials are present.

UNIVERSAL PRECAUTIONS
It is the policy of the Texas Woman’s University to utilize Universal Precautions. Universal Precautions is a system of infection control which assumes that all human blood and certain body fluids are treated as if known to be infectious for HIV, HBV and other bloodborne pathogens. Universal Precautions shall be consistently used for all individuals.

Implementation of Universal Precautions does not eliminate the need for other category or disease-specific isolation precautions.

Body fluids which are directly linked to the transmission of HBV and/or HIV to which Universal Precautions apply are blood, blood products, semen, vaginal secretions, cerebrospinal fluid, synovial fluid, pleural fluid, peritoneal fluid, pericardial fluid, amniotic fluid, saliva in dental procedures and concentrated HIV and/or HVB viruses. Universal Precautions also apply to body tissues and any other human body fluids visibly contaminated with blood.

Although saliva has not been implicated in HBV and/or HIV transmission, to minimize the need for emergency mouth to mouth resuscitation, mouthpieces, resuscitation bags, and other ventilation devices shall be available for use in areas in which the need for resuscitation is predictable.

All health care workers and emergency response personnel shall routinely use appropriate barrier precautions to prevent skin and mucous membrane exposure when contact with blood or other body fluids is anticipated. A supply of non-sterile gloves shall be made available by the departments employing these personnel and this equipment shall be worn when it is apparent that contact with blood or body fluids is reasonably expected. Other items such as long sleeve gowns, aprons, masks, shoe covers, and eye shields shall also be available to employees in identifiable situations. To ensure their effectiveness, these protective barriers shall be examined by the supervisor on at least an annual basis. The type of barrier chosen depends on the situation. In general, the selection of the type of protective barrier or equipment or work practice will include the consideration of the probability of exposure, the type and amount of blood or body fluid, as well as the route of transmission. If a procedure or situation is likely to generate splashing, spraying, splattering and generation of droplets of blood and/or body fluids beyond the protective barrier provided by gloves, then it is the responsibility of the individual employee to obtain the needed protective equipment prior to undertaking the procedure.

In the event that unexpected splashing occurs in an unprotected situation, cleaning facilities shall be made available for the employee as soon as is feasible.

Hands and other skin surfaces shall be washed immediately and thoroughly if contaminated with blood or other body fluids. Hands shall be washed immediately after gloves are removed. It is not acceptable to wash gloves. One should always remove gloves, wash hands, and apply clean gloves if attending to more than one person.

To prevent needle-stick injury, contaminated needles or other sharps must not purposely be bent, sheared, broken, recapped(except by employing a one-handed technique), removed from disposable syringes, or otherwise manipulated by hand. They shall be disposed of in sharps containers.

Health care workers and emergency response personnel shall take precautions to prevent injuries caused by needles, scalpels, and other sharp instruments during routine procedures such as cleaning used instruments or during disposal of used needles, and when handling sharp instruments after procedures.

After use, disposable syringes and needles, scalpel blades, and other sharp items shall be placed in puncture-resistant sharps containers for disposal. The puncture-resistant container should be located as close as practical to the use area and identified as a biohazard.

Gloves must be worn if the hands of the caregiver are not intact. Employees who have exudative lesions or weeping dermatitis shall refrain from all direct contact with patients or victims and from handling patient care equipment until the condition resolves.

Universal Precautions will be accomplished as follows:
Gloves are worn when direct contact with blood and visibly blood tinged body substances can reasonably be expected, including contact with blood and body fluids, mucous membranes, non-intact skin of individuals, handling of items or surfaces soiled with blood or body fluids, and for performing venipuncture and other vascular access procedures.

Gloves are to be changed after contact with each patient or victim.

Gloves are put on prior to beginning a task and removed when the task is complete. Hands are washed after removal of gloves or other personal protective equipment. Sterile gloves should be worn for invasive aseptic procedures.

NOTE: Gloves are worn for all procedures where a potential exists for exposure to blood or body fluids.

The procedures will include, but not be limited to:
• Perineal care
• Catheter care
• Oral care
• Suctioning
• Treatment/dressing changes
• Venipuncture
• Handling of contaminated trash
• Handling of soiled laundry/linens
• Cleaning body fluids spills
• Cleaning blood spills

Hand-washing with soap and water is mandatory between each patient or victim contact and should be done whenever hands are visibly soiled. The employing department will provide hand cleanser and clean cloth/paper towels or antiseptic towelettes. When antiseptic hand cleanser or towelettes are used, hands must be washed with soap and running water as soon as feasible.

Gowns and disposable aprons are only needed when it is likely that blood or visibly bloody substances will soil clothing or skin.

Masks are only needed when it is likely that nose and mouth will be splashed with moist body substances or when personnel are working directly in or around areas of large open wounds.

Eye shields, goggles, or face shields are only needed when there is a likelihood that the eyes may be splashed with body fluids.

Contaminated needles or other sharps must not be bent, sheared, broken or recapped by hand (unless using a one-handed technique). Needles and other sharps must be discarded in rigid, leak proof-puncture resistant containers for disposal. The puncture resistant sharps container should be located as close as practical to the use area, and identified as biohazard. To prevent recapping by hand, re-sheathing of needles may be accomplished with the aid of a re-sheathing instrument, self-sheathing needles or forceps.

Linen soiled with blood or blood tinged body fluids must be gathered without undue agitation and placed in a leak-proof bag for transportation to the laundry. Bagging should occur at the location where it was used, however double bagging is not necessary.

Containers used for waste containment must be large enough to hold all contents and must prevent leakage of fluids during handling, storage, transport or shipping. If outside contamination of the container occurs, a second container shall be used to encase the first.

Housekeeping - Environmental surfaces such as walls, floors, and other surfaces are not associated with transmission of infections to either patients/victims or employees, therefore, attempts to disinfect or sterilize are not necessary. However, changing and removal of soil should be done routinely using products that, according to the manufacturer instructions, are effective for the required sanitation outcome.

Laundry- Because the risks of disease transmission from soiled linen is negligible, hygienic and common sense storage and processing of clean and soiled linen is recommended. Soiled linens should be handled as little as possible. Linens should be washed with detergent and hot water (at least 60 degrees C for 25 minutes) or if lower temperature cycles are used, with chemicals suitable for low temperature washing at proper use concentration.

If an employee has an exposure incident, the employee shall file an accident report with his/her supervisor as soon as possible. The medical evaluation of these incidents is covered under Worker’s Compensation law. The medical examiner will recommend appropriate testing, as needed for HIV and/or HBV. The schedule for future testing, as needed, will also be recommended to the exposed employee by the medical provider. This testing regimen is often as follows: within 14 days of the incident, at 6 weeks, at 12 weeks, and at 6 months following the incident. The exposed employee must advise the medical provider that the exposure incident/injury is a work-related incident. The evaluation of the source individual, if the person’s identity is known, may not be covered by Worker’s Compensation. The hospital, clinic or laboratory where the incident occurred must be prepared to cover the evaluation of the source individual. Proper consent for laboratory testing must be obtained from all individuals involved. Confidentially of medical records in each case must be preserved per Texas law. No release of medical information regarding parties involved will occur without proper release documentation and medical "need to know".

An evaluation of any incident that exposed or potentially exposed an employee (or student or volunteer) to infection with bloodborne pathogens shall be undertaken collaboratively by the health care provider, Human Resource Office and Risk Management Office. A description of the corrective action taken to prevent recurrence of similar exposures shall be recorded.

For each incidence of mucous membrane or parenteral exposure to body fluids or tissue, a description of the exposure and any corrective action taken to prevent recurrence shall be documented by the employing department in collaboration with the Risk Management Office. Progressive discipline will occur for any employee that fails to comply with Universal Precautions. Documentation will include the employee infraction and the corrective action taken by the facility to bring the employee into compliance. Standard University disciplinary procedures will be followed.

ENGINEERING AND WORK PRACTICE CONTROLS
Engineering and work practice controls will be used to eliminate or minimize employee exposure. Where occupational exposure remains after institution of these controls, personal protective equipment will also be used. Engineering controls shall be examined at least annually to ensure their effectiveness. The area supervisor shall be responsible for inspections and maintaining inspection records.

The employing department shall provide hand-washing facilities which are readily accessible to employees. When provision of hand-washing facilities is not feasible, the employing department will provide either an appropriate antiseptic hand cleanser in conjunction with clean cloth/paper towels or antiseptic towelettes. When antiseptic hand cleansers or towelettes are used, hands will be washed with soap and running water as soon as feasible.

Employees shall wash their hands immediately or as soon as feasible after the removal of gloves or other personal protective equipment.

Employees shall wash their hands and any other skin with soap and water, or flush mucous membranes with water immediately or as soon as feasible, following contact of such body areas with blood or other potentially infectious materials.

HOUSEKEEPING
The Texas Woman’s University, through its employing departments, requires that work-sites involving bloodborne pathogenic materials are maintained in a clean and sanitary condition. For example, the Student Health Services, School of Nursing, Dental Hygiene Clinic, other clinics and all research laboratories utilizing blood and other potentially infectious materials shall prepare written Infection Control Plan that include the methods of decontamination based upon the location in the facility, type of surface to be cleaned, type of soil present, and tasks or procedures being performed in the area. The schedule for cleaning and the Infection Control Plan shall be followed, kept in departmental office and it shall be made accessible to employees and Safety Office.

All equipment, environmental and working surfaces will be cleaned and decontaminated after contact with blood or potentially infectious materials.

Contaminated work surfaces will be decontaminated with an appropriate disinfectant aftercompletion of a procedure immediately or as soon as feasible, when surfaces are overtly contaminated, or after any spill of blood or other potentially infectious materials and at the end of the work shift if the surface has become contaminated since the last cleaning.

Protective coverings, such as plastic wrap, aluminum foil, or imperviously-backed absorbent paper used to cover equipment and environmental surfaces shall be removed and replaced at the end of the work shift, if they became contaminated during the shift. Heavilycontaminated coverings may need to be replaced several times during a shift.

All bins, pails, cans, and similar receptacles intended for reuse, which have a reasonable likelihood for becoming contaminated with blood or other potentially infectious materials, shall be inspected, cleaned and decontaminated at least weekly or as soon as feasible, upon visible contamination by the lab coordinator.

Broken glassware which may be contaminated shall not be picked up directly with the hands. It shall be cleaned up by mechanical means, such as brush and dustpan, tongs or forceps and be disposed of in an appropriate sharps container.

SPECIMENS AND EQUIPMENT
All procedures involving blood or other potentially infectious materials will be performed in such a manner as to minimize splashing, spraying, spattering, and generation of droplets of these substances.

Mouth pipetting or suctioning of blood or other potentially infectious materials is prohibited.

Specimens of blood or other potentially infectious materials must be placed in a container that prevents leakage during collection, handling, processing, storage, transport, or shipping.

The container for storage, transport or shipping shall be labeled biohazard or color-coded and closed prior to being stored, transported or shipped. When using Universal Precautions in the handling of all specimens, the label/color-coding of specimens is not necessary, provided the containers are recognizable as containing specimens AND as long as the specimen remains in the facility. Biohazard labeling or color-coding is required if and when the specimen container leaves a facility.

If there is outside contamination of the primary container, the primary container must be placed within a secondary container that is puncture-resistant in addition to the above characteristics.

Equipment that may become contaminated with blood or other potentially infectious material must be examined prior to servicing or shipping and must be decontaminated as needed, unless it can be demonstrated that the decontamination of such equipment or portions of such equipment is not feasible. If the equipment can't be decontaminated, then a readily observable biohazard label must be attached to the equipment.

It is the responsibility of all employing departments of the University to ensure that this information is conveyed to all affected employees as appropriate, prior to the handling, servicing, or shipping of contaminated materials, so that appropriate actions can be taken.

HAZARD COMMUNICATION
Warning labels must be affixed to containers of regulated waste, refrigerators and freezers containing blood or other potentially infectious materials, and other containers used to store, transport or ship blood or other potentially infectious materials. Labels required include the International Biohazard Symbol.
The Biohazard label shall be fluorescent orange or orange-red with lettering or symbols in a contrasting color.
Labels must be affixed as close as feasible to the container by string, wire, adhesive or other method that prevents their loss or unintentional removal.

Red bags or red containers may be substituted for labels.
Containers of blood, blood components or blood products that are labeled as to their contents and have been released for transfusions or other clinical use are exempted from the labeling requirements.

Individual containers of blood or other potentially infectious materials that are placed in a labeled container during storage, transport, shipment or disposal are exempted from the labeling requirement. Contaminated equipment shall be labeled and shall state which portions of the equipment is contaminated.

Regulated waste that has been decontaminated need not be labeled or color-coded.

PERSONAL PROTECTIVE EQUIPMENT
Personal protective equipment (PPE) is specialized clothing worn by an employee for protection against a hazard. General work clothes, not intended to function as protection against a hazard, are not considered to be personal protective equipment.

When there is a potential for occupational exposure, the employing department will provide, at no cost to the employee, appropriate personal protective equipment such as, but not limited to, gloves, gowns, laboratory coats, face shields or masks, eye protection, mouthpieces, pocket masks and/or other ventilation devices. Personal protective equipment is considered appropriate only if it does not permit blood or other potentially infectious materials to pass through or reach the employee's work clothes, street clothes, undergarments, skin, eyes, mouth, or other mucous membranes under normal conditions of use and for the duration of time which the protective equipment will be used.

It is the employing department's responsibility to ensure that employees use appropriate personal protective equipment. Under rare and extraordinary circumstances an employee may exercise professional judgement that in a specific situation the use of such equipment would have prevented the delivery of health care or public safety services, and/or would have posed an increased hazard to the safety of the worker. When the employee makes such a judgement, it must be shown that the employee temporarily and briefly declined to use personal protective equipment, and the circumstances must be investigated and documented in order to determine whether changes can be instituted or to prevent such occurrences in the future.

The employing department will ensure the appropriate personal protective equipment, in the appropriate sizes, is readily accessible at the work-site. Hypoallergenic gloves, glove liners, powderless gloves, or other similar alternatives will be readily accessible to those employees who are allergic to the gloves normally provided.

The employing department shall clean, launder and dispose of personal protective equipment and will repair or replace personal protective equipment as needed to maintain its effectiveness, at no cost to the employee.

If blood or other potentially infectious materials penetrate a garment, the garment(s) will be removed immediately or as soon as feasible.

All personal protective equipment will be removed prior to leaving the work area, and placed in an appropriate designated area or container for storage, washing, decontamination or disposal.

Gloves will be worn when it can be reasonably anticipated the employee may have hand contact with blood, other potentially infectious materials, mucous membranes, and non-intact skin when performing vascular access procedures, and when handling or touching contaminated items or surfaces.

Disposable (single use) gloves will be replaced as soon as practical when contaminated, or as soon as feasible if they are torn or punctured, or when the ability to function as a barrier is compromised. Disposable (single use) gloves will not be washed or decontaminated for reuse.

Utility gloves may be decontaminated for reuse if the integrity of the glove is not compromised. However, they must be discarded if they are cracked, peeling, torn, punctured or exhibit other signs of deterioration, or when the ability to function as a barrier is compromised.

Masks in combination with eye protection devices, such as goggles or glasses with solid side shields or chin-length face shields, shall be worn whenever splashes, spray, spatter, or droplets of blood or other potentially infectious materials may be generated, and eye, nose, or mouth contamination can reasonably be anticipated.

Appropriate protective clothing such as, but not limited to, gowns, aprons, lab coats clinic jackets, or similar outer garments will be worn in occupational exposure situations. The type and characteristics will depend upon the task and the degree of exposure anticipated.

Surgical caps or hoods and/or shoe covers or boots need only be worn in situations when gross contamination can be reasonably anticipated.

FOOD AND DRINKS
Eating, drinking, smoking, applying cosmetics or lip balm, and handling contact lenses are prohibited in work areas where there is a reasonable likelihood of occupational exposure.
Food and drinks will not be kept in refrigerators, freezers, shelves, cabinets, on counter tops, or bench tops where blood or other potentially infectious materials are present.

MEDICAL SERVICES
HEPATITIS B VACCINATION
Hepatitis B is a type of viral hepatitis acquired from exposure to human blood and body fluids that results in liver inflammation. While the use of Universal Precautions helps in the protection from Hepatitis B, the Hepatitis B vaccine is an additional measure offered to all employees in Category I and Category II through the Student Health Services (SHS)-Denton Campus and of course through your own personal physician. NOTE: The cost of the vaccination for employees is charged back to the employing department. Departments with employees classified as Category I or Category II must establish accounts for the charges with the Student Health Service business office. Denton Campus employees have the option to contact their personal health care provider for this service. Employees at the Dallas and Houston Centers shall contact their personal health care provider for the vaccine and shall be reimbursed for the co-pay by the employing departments.

NOTE- Students, volunteers and "Good Samaritans" are not eligible for the vaccination payment by the University and must arrange for payment through the Student Health Service business office or make alternate arrangements with other qualified health care providers.

NOTE: Employees classified as Category I or Category II wishing to obtain HBV vaccination from other sources must assume personal financial responsibility for the cost of the vaccination and must offer acceptable proof of vaccination to the employer.

As part of the employment process, education and training will be provided regarding the Hepatitis B vaccine. This training record must be maintained for a minimum of 3 years from the date on which the training occurred and maintained in the employee’s personnel file.

At a minimum, this training will include efficacy, safety, method of administration, benefits of being vaccinated, and the fact that the vaccine is available at convenient times in-house at no charge to any employee where occupational exposure may take place.

This training will be provided during working hours at no cost to the employee by a health care or safety professional, knowledgeable in the subject matter as it relates to the workplace.

Following the required training, all employees in Category I and Category II will be offered the Hepatitis B vaccine, within 10 working days of initial assignment unless the employee has previously received the complete Hepatitis B vaccination series and antibody testing has revealed that the employee is immune or if the vaccine is contraindicated for medical reasons (e.g. allergic to yeast).

All employees offered the Hepatitis B vaccine must complete the Consent Form for Hepatitis B Vaccination.

Once completed, the Consent Form shall be placed in the employee's permanent record at the Department of Human Resources.

For those desiring the Hepatitis B vaccine, an Employee Immunization Record will be maintained until each of the 3 steps of the vaccination process is complete with the employing office and eventually placed into the employee’s personnel file.

POST EXPOSURE FOLLOW-UP
The source (if known) individual’s blood will be collected as soon as feasible and tested after consent is obtained. Results of the source individual's testing will be made available to the exposed employee, and the employee will be informed of applicable laws and regulations concerning disclosure of the identity and infectious status of the source individual.

The exposed employee's blood will be collected as soon as feasible and tested after consent is obtained. It is the responsibility of the medical provider, evaluating the exposure/inquiry to make appropriate recommendations for laboratory testing (for HBV/HIV) and for any needed future re-evaluations.

If the employee consents to baseline blood collection, but does not give consent at that time for HIV serologic testing, the sample shall be preserved for at least 90 days. If within 90 days of the exposure incident, the employee elects to have the baseline sample tested, such testing shall be done as soon as feasible.

Post-exposure treatment, when medically indicated, as recommended by the Centers for Disease Control includes counseling, possible medical treatment and the evaluation of the reported illnesses.

The Worker’s Compensation Coordinator will provide the healthcare professional evaluating an employee after an exposure incident with the following information:
A description of the exposed employee's duties as they relate to the exposure incident.

Documentation of the route(s)of exposure and the circumstances under which the exposure occurred.
Information on how to access the results of the source individual's blood testing, if available.
All medical records relevant to the appropriate treatment of the employee including vaccine status will be provided to the medical provider by the patient/employee.
The health care professional will provide the employer with a copy of the evaluating healthcare professional’s written opinion within 15 days of the completion of the evaluation.
The healthcare professional's written opinion for post-exposure evaluation and follow-up shall be limited to include only that the employee has been informed of the results of the evaluation and that the employee has been told about any medical conditions resulting from exposure to blood or other potentially infectious materials which will require further evaluation or treatment. All other findings or diagnoses shall remain confidential and shall not be included in the written report.

In keeping with these principles, the university wide procedure to use for initiating post-exposure care is as follows:
An employee who experiences an exposure incident must cease work and report it immediately to her/his supervisor, even if the employee does not feel the exposure poses a risk for contracting bloodborne disease.

The supervisor, together with exposed employee, must immediately fill out the "Employer's First Report of Injury or Illness" form and other applicable TWCC forms including the TWU Post-Exposure Incident Report Form. Please contact the Human Resource Office for more details.

The employee reports to the SHS or personal health care provider with a copy of the report forms in hand;

The SHS or personal health care provider confirms that an exposure incident has occurred and ensures that the information recorded on the forms meets the requirements for documenting exposures;

Following the exposure incident, the medical provider, Sfety Office and the Risk Manager review the circumstances surrounding the exposure incident and, if warranted, review and recommend revision of the Exposure Control Plan to the University Safety Committee to reduce the likelihood of a similar incident in the future.

INFECTIOUS WASTE, BLOODSPILLS, CONTAMINATED SURFACES AND CONTAMINATED LAUNDRY

CAMPUS-WIDE INFECTIOUS WASTE MANAGEMENT
Infectious waste which is disposed of by means other than washing into the sewer system is regulated by federal, state and local laws and is termed "regulated waste" or "contaminated waste". Regulated wastes will be placed in containers that are closable, constructed to contain all contents and prevent leakage of fluids during handling, storage, transport or shipping. These containers will be labeled biohazard or color-coded (red bagged) and closed prior to removal to prevent spillage or protrusion of contents during handling, storage, transport, or shipping.

If outside contamination of the regulated waste container occurs, it will be placed in a second container. The second container will be closable, constructed to contain all contents and prevent leakage of fluids during handling, storage, transport, or shipping and be labeled biohazard or color-coded. The container must be closed prior to removal to prevent spillage or protrusion of contents during handling, storage, transport, or shipping.

If regulated waste is stored prior to disposal, it must be stored in a secure area that is locked or otherwise secured to eliminate access by the general public, and must be afforded protection from adverse environmental conditions and vermin.

The following specific procedures and precautions must be followed for the handling, treatment and disposal of regulated infectious wastes:
All sharps must be disposed of in sharps containers, regardless of other protective features built into the tool such as self-sheathing needles. Sharps containers must meet the criteria established by the Bloodborne Pathogens Rule and must be available wherever sharps are used for University-related procedures. Sharps containers are purchased by departments or research projects with departmental or project funds.

The efficacy of steam autoclaving and chemical sterilization procedures must be verified through methods recommended by the Centers for Disease Control (CDC), for example, the use of biological indicators indicators.

Liquid infectious wastes shall be disposed in the sanitary sewer only when volumes are so large as to preclude the feasibility of autoclaving and when using the precautions listed. A sink must be dedicated for this purpose and set aside from other uses through appropriate signs (personnel must wear gloves, goggles, face shield and splash protection)• personnel shall be trained in the techniques to use to minimize the risk of exposure and contamination, in particular, the infectious waste shall be poured in a manner so as to minimize, as much as possible, the generation of aerosols;• the sink and surrounding surfaces shall be decontaminated with a 1:10 solution of bleach in water (Clorox or equivalent) and the drain shall be flushed with the same solution each time it is used;• plumbers servicing drain pipes used for infectious waste disposal shall be informed of the potential hazard of liquid infectious waste being retained in the lines and advised to wear suitable personal protective equipment.

Untreated infectious waste shall not be shipped off-site unless it is hauled by a licensed transporter to a licensed infectious waste treatment facility. Treated infectious waste may only be disposed in the normal trash if labels and markings that identify the waste to be infectious are removed or defaced.

At the Texas Woman’s University infectious wastes will be autoclaved until sterility is achieved. Biohazard materials markings will be removed and the non-hazardous wastes will be disposed of in the normal trash dumpsters.

SHARPS
Contaminated needles and other contaminated sharps must not be bent, recapped or removed unless it can be demonstrated that no other alternative is feasible or that such action is required by a specific medical procedure. If necessary, recapping or needle removal must be accomplished through a mechanical device or a one-handed technique. Shearing or breaking of contaminated needles is strictly prohibited.

Disposable contaminated sharps will be discarded immediately or as soon as feasible in containers that are closable, puncture resistant, leak-proof on the sides and bottom and labeled biohazard or color-coded.

During use, containers for contaminated sharps will be easily accessible to personnel and located as close as feasible to the immediate areas where sharps are used or can be reasonably anticipated to be found, should be maintained upright throughout use, replaced routinely and not be allowed to be overfilled.

When moving containers of contaminated sharps from the area of use, the container must be closed immediately prior to removal or replacement to prevent spillage or protrusion of contents during handling, storage, transport, or shipping.

If leakage is possible, a secondary container must be used. The second container must be closable, constructed to contain all contents and prevent leakage during handling, storage, transport or shipping and be labeled biohazard or color-coded. Reusable containers shall not be opened, emptied or cleaned manually, or in any other manner that would expose employees to the risk of percutaneous injury.

ON-SITE TREATMENT
Autoclaving and Chemical Sterilization: Steam autoclaving is a suitable treatment technique for small volumes of infectious wastes. These include used first aid supplies, blood spill clean up sorbents, liquids, and other small volumes of infectious wastes.

Chemical sterilization is accomplished by use of ethylene oxide, glutaraldehyde solutions, isolyzer compounds or dilute bleach solutions. Glutaraldehydes solutions, isolyzer compounds or bleach solutions are practical for small blood spills such as lacerations or bloody noses.

Whatever treatment procedure is used, red bags should not be used for the disposal of TREATED infectious waste in the normal trash.

Management of Liquid Infectious Waste Via the Sanitary Sewer: The wastewater treatment system is a sufficiently hostile environment for the HIV and HBV viruses and other pathogenic organisms so the TDH allows liquid infectious wastes to be disposed of to the sewer. However, this practice involves a high degree of risk of exposure to personnel conducting the activity. Caution must be observed. The risk to plumbers will be minimal if the drains are flushed with a suitable disinfectant every time they are used.

OFF-SITE DISPOSAL
Licensed commercial infectious waste management contractors must be utilized if off- site disposal is needed. Moreover, TDH infectious waste transportation regulations prohibit campus employees from transporting infectious wastes to area hospitals or other facilities for disposal.

HANDLING CONTAMINATED LAUNDRY
Contaminated laundry will be handled as little as possible with a minimum of agitation.

Contaminated laundry will be bagged or containerized at the location where it was used and shall not be sorted or rinsed in the location of use. The contaminated laundry will then be placed and transported in bags or containers labeled as biohazard or color-coded red.

When Universal Precautions are utilized in the handling of all soiled laundry, alternative labeling or color-coding is sufficient, if it permits all employees to recognize the containers as requiring compliance with Universal Precautions. Whenever contaminated laundry is wet and presents a reasonable likelihood of soak-through of or leakage from the bag or container, the laundry shall be placed and transported in bags or containers that prevent soak-through and/or leakage of fluids to the exterior.

The departmental supervisors shall ensure that employees who have contact with contaminated laundry wear appropriate personal protective equipment.

FEMININE HYGIENE PRODUCTS
OSHA has issued a statement indicating that it does not include soiled sanitary napkins and other feminine hygiene products in the definition of regulated waste because they are designed so as to prevent the release of liquid or semi-liquid blood or the flaking off of dried blood. Therefore, employees handling such wastes are not covered by the Bloodborne Pathogens Rule solely due to that duty. However, OSHA does expect that containers for soiled sanitary products to be lined with a plastic or wax paper bag and that employees be provided suitable gloves for removal of the bags from the waste container.

BLOOD SPILLS
Blood spills on non-porous surfaces can very simply be handled by diluting the spill with an equal volume of 1:10 household bleach solution, or with other EPA registered disinfectants, and then absorbing it with disposable toweling or absorbent pads. This approach is used in hospitals and exceeds the guidelines issued by the CDC. If the spill involves any broken glassware, it must be picked up using a mechanical means, such as a brush and dustpan, tongs or forceps. In cases where the absorbent becomes saturated with blood and bleach, the spill clean up materials should be autoclaved prior to being disposed of in the normal trash.

There are also a number of "clumping" powdered products (e.g. Vital 1, Isolyzer) that absorb and solidify blood spills and chemically treat them at the same time. There are also products that fix sharps in a plastic polymer while treating them by heat and chemical disinfectant (e.g. Isolyzer). While these methods are effective and convenient they are very expensive compared to bleach and absorbent material and have not yet withstood the "test of time". Bleach or other EPA approved disinfectants are most highly recommended.

CONTAMINATED SURFACES
Exact procedures will depend upon Departmental activities and needs. In general, the following principles established by the CDC should be followed:

Decontamination shall be carried out after completion of specified procedures or as soon as possible when surfaces are overtly contaminated or after any spill of blood or other potentially infectious material,

Decontamination shall also be carried out at the end of the work shift if the surface may have become contaminated since the last cleaning.

The same principles apply to protective coverings on equipment and environmental surfaces (e.g. floors, walls, bench-tops).

All bins, pails, cans and similar receptacles intended for reuse which have a reasonable likelihood for becoming contaminated with blood or other potentially infectious materials shall be inspected and decontaminated on a regularly scheduled basis and cleaned and decontaminated immediately or as soon a feasible upon visible contamination.

INFORMATION AND TRAINING
The Texas Woman’s University will ensure that all employees with the potential for occupational exposure will have an opportunity to participate in a training program that will be provided at no cost to the employee and will be provided during working hours.

Departmental Supervisors shall ensure that training be provided at the time of initial assignment to tasks where occupational exposure may take place and at least annually thereafter, within one year of their previous training using material appropriate in content and vocabulary to the educational level, literacy, and language of the employees. The Texas Woman’s University will provide additional training when changes, such as modifications of tasks, changes in procedures, institution of new tasks or procedures affect the employees risk for occupational exposure. The additional training will be limited to addressing the new exposures created.

For Level I employees and those Level II employees with occupational exposure to bloodbome pathogens the training program will contain the following elements:
An accessible copy of the regulatory text of this standard and an explanation of its contents.

A general explanation of the epidemiology and symptoms of bloodborne diseases.

An explanation of the modes of transmission of bloodborne pathogens.

An explanation of the Exposure Control Plan and the means by which the employee can obtain a copy of the written plan.

An explanation of the appropriate methods for recognizing tasks and other activities that may involve exposure to blood and other potentially infectious materials.

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.

Information on the types, proper use, location, removal, handling, decontamination, and disposal of personal protective equipment.

An explanation of the basis for selection of personal protective equipment.

Information of 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 (except for students and volunteers and class III employees).

Information on the appropriate actions to take and persons to contact in an emergency involving blood or other potentially infectious materials.

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.

Information on the post-exposure evaluation and follow-up that will provide for the employee following an exposure incident.

An explanation of the biohazard signs and labels and/or color-coding required by the facility and by law.

An opportunity for interactive questions and answers with the person conducting the training.

For Level III employees and those Level II employees without occupational exposure to bloodborne pathogens, the training program will contain the following elements:

Basic understanding about the subject of bloodborne diseases and how they are transmitted.

Basic training on how employees are expected to respond to situations involving blood, if they unexpectedly encounter it.

Basic training of post-exposure follow-up and how it would apply to employees if they were exposed.

A video training session supplemented with basic handout material will be the primary training methodology for this group.

The person conducting the training will be knowledgeable in the subject matter covered by the elements contained in the training program as it relates to the workplace/facility.

Training records will include the following information:
The dates of the training sessions.
The contents or a summary of the training sessions.
The names and qualifications of the person(s) conducting the training.
The signed names and job titles of all persons attending the training sessions.
A means of assessing learning.

Training records will be maintained for 3 years in the safety office from the date on which the training occurred.

Employee training records will be provided upon request for examination and copying to employees and employee representatives, and others as required by law.

STUDENTS
Students (non-employed) are, strictly speaking, not covered by the Bloodborne Pathogens Rule except for the general sections of Texas Department of Health code pertaining to "Safe Place" for scholarly work and study. However, it is the mission of the Texas Woman’s University to provide students with adequate training so they may pursue their studies and eventually their careers safely and knowledgeably. Therefore, the University has identified those curricula which involve reasonably anticipated exposure of students to blood or other potentially infectious materials. The use of blood must be evaluated in light of its risk to students and the fulfillment of each department's academic mission. When possible, alternatives to the use of blood and other potentially infectious materials must be adopted. Alternatives include the use of non-infectious animal blood, synthetic blood or computer simulations. (Note that "Screened Blood" from a blood bank is not 100% safe, must be handled using Universal Precautions, and requires the same training, precautions and protective equipment as unscreened blood). For curricula where alternatives are not feasible, the policies of this section (see below) must be followed.

Exposure Control Plan:
Departments which require students to work with blood or other potentially infectious materials must follow the TWU Exposure Control Plan.

Training: Departments which require students to work with blood or other potentially infections materials must provide at least the same level of training as outlined in the TWU Bloodborne Pathogens Exposure Control Plan. For students in laboratory or clinical settings (on campus or off) advanced training must be provided by qualified professors and/or instructors.

Personal Protective Equipment (PPE): Departments which require students to work with blood or other potentially infections materials must provide at least the same level of personal protective equipment as outlined in the TWU Bloodborne Pathogens Exposure Control Plan. Students may be required to purchase the equipment and should be advised of this requirement well in advance. Moreover, students must be provided training in the proper use of personal protective equipment in advance of its use.

Hepatitis B Vaccination: Departments which require students to work with blood or other potentially infections materials must make available to students a Hepatitis B vaccination as outlined in the TWU Bloodborne Pathogens Exposure Control Plan. Students will be required to pay for the vaccination and should be advised of this requirement well in advance, as well as where they may obtain the vaccination (Student Health Services) and what it will cost (check with Student Health Services Business Office).

Post Exposure Follow Up: Departments which require students to work with blood or other potentially infections materials must advise students that they should notify their health insurance carriers of their academic activities involving bloodborne pathogenic materials.

Management of Infectious Wastes and Contaminated Laundry: Students who are not employees of TWU must not handle, treat or sewer dispose of infectious wastes, other than to immediately containerize infectious waste generated by their laboratory procedures. Students who are not employees are also prohibited from handling contaminated laundry for University-related purposes. Strict regulations govern the handling, treatment and disposal of infectious wastes, therefore, these activities are restricted to designated employees of the University.

VOLUNTEERS AND GOOD SAMARITIANS
Volunteers are used at TWU to further University programs. As with students, however, volunteers are not covered by the Bloodborne Pathogens Rule except for the general sections of the code pertaining to maintaining a "Safe Place" for scholarly work and study. Therefore, because of their unofficial status, it is expected that volunteers will not be placed in situations where they would be exposed to bloodborne pathogens. However, in rare circumstances where a volunteer may possess special skills or knowledge and where it would be impossible to utilize this expertise without the risk of exposure to blood or other potentially infectious materials, exceptions may be permitted. In these situations the use of blood must be evaluated in light of its risk to the volunteer and the academic mission which requires the volunteer's expertise. When possible, alternatives to the use of blood and other potentially infectious materials must be adopted. Alternatives include the use of non-infectious animal blood, synthetic blood or computer simulations. (Note that "Screened Blood" from a blood bank is not 100% safe, must be handled using Universal Precautions, and requires the same training, precautions and protective equipment as unscreened blood). For projects where alternatives are not feasible, approval must be obtained from Environmental Safety and Health Officer or the Risk Manager and the policies of this section (see below) must be followed.

"Good Samaritains", students, volunteers, and members of the general public who are not expected to provide First Aid or CPR but who may have had First Aid or CPR training and wish to provide First Aid or CPR services in an emergency. These individuals are not included in the Bloodborne Pathogens Plan and are not considered eligible for post exposure follow up or HBV vaccination. It is recommended that if these individuals are exposed to blood or other potentially infectious material in the course of rendering First Aid or performing CPR that they seek follow up medical attention from a qualified health care provider.

Exposure Control Plan:
Volunteers approved to work with blood or other potentially infectious materials must follow the TWU Bloodborne Pathogens Exposure Control Plan.

Training: Volunteers approved to work with blood or other potentially infections materials must receive at least the same level of training as outlined in the TWU Bloodborne Pathogens.

Personal Protective Equipment: Volunteers approved to work with blood or other potentially infections materials must be provided with at least the same level of personal protective equipment as outlined in the TWU Bloodborne Pathogens Exposure Control Plan. Volunteers may be required to purchase the equipment and should be advised of this requirement well in advance. Moreover, volunteers must be provided training in the proper use of personal protective equipment in advance of its use.

Hepatitis B Vaccination: Volunteers approved to work with blood or other potentially infections materials must obtain a Hepatitis B vaccination as outlined in the TWU Bloodborne Pathogens Exposure Control Plan. Volunteers will be required to pay for the vaccination and should be advised of the requirement well in advance. Volunteers must consult with their personal physician. Proof of vaccination or refusal of vaccination must be on file with the designated department.

Post Exposure Follow Up: Volunteers approved to work with blood or other potentially infections materials must be advised that they should notify their health insurance carriers of their academic activities involving bloodborne pathogenic materials.

Management of Infectious Wastes and Contaminated Laundry: Volunteers who are not employees of TWU must not handle, treat or sewer dispose of infectious wastes, other than to immediately containerize infectious waste generated by their laboratory procedures. Volunteers who are not employees are also prohibited from handling contaminated laundry for University-related purposes. Strict regulations govern the handling, treatment and disposal of infectious wastes, therefore, these activities are restricted to designated employees of the University.

RECORDKEEPING
The Texas Woman’s University’s Department of Human Resources will establish and maintain an accurate record for each employee with occupational exposure, to include:
The name and social security number of the employee.
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 the vaccination.
A copy of all results of examinations, medical testing, and follow-up procedures.
The University's copy of the healthcare professional's written opinion.
A copy of all information provided to the healthcare professional.

The facility will ensure that the employee's medical records are kept confidential and are not disclosed or reported without the employee's express written consent to any person within or outside the workplace except as required by law.The facility will maintain the records for employees with occupational exposure for at least the duration of employment PLUS an additional 30 years. Employee medical records shall be provided upon request for examination and copying to the subject employee, to anyone having written consent of the subject employee or others as required by law.

IMPLEMENTATION
Information and Training/Recordkeeping
In September 1998 the University will begin providing training for employees with possible occupational exposure. A training program will also be provided for new employees at the time of initial assignment to tasks that may involve occupational exposure. Additional training will be provided as changes occur that will affect an employees occupational exposure status, as well as annual training, Training will be provided by a professional knowledgeable in the subject matter covered. The Human Resource Department will be responsible for the record retention for a minimum of three (3) years.

TEXAS WOMAN’S UNIVERSITY

CONSENT/DECLINATION FORM FOR HEPATITIS B VACCINE

________ Yes, I do wish to be vaccinated with the Hepatitis B Vaccine Series.

I understand that it is my responsibility to be present for the entire series of inoculations for the HBV Vaccine.

If I fail to be present for the scheduled inoculation, I will meet with the appropriate person to reschedule my inoculations.

______I have previously completed the Hepatitis B vaccination series and the antibody testing has revealed that I am immune. (Attached copy of antibody testing.)

______I am not to take the Hepatitis B vaccination due to medical reasons. (Attached physician's statement)

______I understand that due to a risk of occupational exposure to blood, and potentially infectious materials, I may be at risk of acquiring Hepatitis B (HBV) infection. I have been given the opportunity to be vaccinated with the Hepatitis B vaccine at no charge to myself. However, I decline the Hepatitis B vaccination at this time. I understand that by declining this vaccine, I continue to be at risk for acquiring Hepatitis B, a serious disease. If in the future, I continue to have occupational exposure to blood or other potentially infectious materials, I retain the right to be vaccinated with the Hepatitis B vaccine.

EmployeeSignature _______________Date_________________________

Department_______________________Job Title____________________

TEXAS WOMAN’S UNIVERSITY

POST-EXPOSURE INCIDENT REPORT FORM

Date:________Time:_______, and location of the incident:______________________

Description of the incident which exposed an employee to blood or other potentially infectious materials; to include the route of exposure and the circumstances in which the incident occurred:

The exposed person:

Name:_______________________________________________________________________________________

Address:_____________________________________________________________________________________

Telephone No’s (work)_____________________________(home)_______________________________________

Check one of the following statements and sign:

Protocol for post-exposure evaluation was described to me and

______ I do agree to post-exposure seriologic testing for HBV and/or HIV

______ I agree only to having baseline blood collection, but do not agree to seriologic testing for

HBV/HIV at this time. This is with the understanding that my blood sample will be

retained for 90 days and I may request serologic testing for HIVand/or HBV anytime up

to that date.

______ I do not agree to post-exposure serologic testing for HBV and/or HIV________ Signature Date

The source person:

Name:_______________________________________________________________________________________

Address:_____________________________________________________________________________________

Telephone No’s: (work)__________________________(home)_________________________________________

Check one of the following statements and sign:

______I do agree to post-exposure serologic testing for HBV and/or HIV.

______I do not agree to post-exposure serologic testing for HBV and/or HIV.

Signature Date:_______________________________________________

Name(s) and telephone number(s) of any witnesses to the exposure incident:

Name Telephone

________________________________________ ______________________________

________________________________________ ______________________________

________________________________________ ______________________________

Supervisor responsible for completing and filing this report:

Name:____________________________________ Title:__________________________

TWUDepartment:___________________________ Office Phone No:_____________

Signature___________________________ Date__________________

TEXAS WOMAN'S UNIVERSITY POLICY

PREVENTION OF TRANSMISSION OF HIV AND HEPATITIS B VIRUS

BY INFECTED HEALTH CARE WORKERS

Texas Woman's University does not require HIV testing of its employees or students. However, such testing may be required by some health care agencies with which the University affiliates for clinical education.

Employees and students who are at risk of occupational exposure to bloodborne pathogens are required to receive vaccination against hepatitis B virus or to provide proof of immunity. Any employee or student who declines to take the hepatitis B vaccine must sign the Hepatitis B Vaccine Declination Form.

Employees and students who furnish health care services in direct patient care situations are subject to Section 85.201-85.206 of the Texas Health and Safety Code. This law provides that:

-health care workers who perform exposure-prone procedures should know their HIV antibody status;

-health care workers who perform exposure-prone procedures and who do not have serologic evidence of immunity to HBV from vaccination or from previous infection should know their HBV antibody status.

-health care workers with exudative lesions or weeping dermatitis shall refrain from all direct patient care and from handling patient care equipment and devices used in performing invasive procedures until the condition resolves;

-all health care workers shall adhere to universal precautions as defined by the Centers for Disease Control of the United States Public Health Service;

HEPATITIS B VACCINE INFORMATION SHEET

Indications for hepatitis B vaccine now include all adolescents and young adults who have not previously been vaccinated, as well as sexually active persons.

Hepatitis B vaccines currently available are made from hepatitis B surface antigen produced by recombinant DNA technology in yeast cells and contain no blood products. Therefore, the current vaccines cannot transmit AIDS or any other infectious disease.

EFFICACY-Hepatitis B vaccines produce protective antibody levels in more than 90 % of healthy individuals when the three-dose regimen is used. The need for a booster dose after 10 years is still being assessed.

DOSAGE SCHEDULE

Dose one: Upon request

Dose two: 1 month after first dose

Dose three: 6 months after first dose

If a dose of vaccine is not completed on time, it is not necessary to start over--it is only necessary to receive the remaining dose(s).

ADVERSE REACTIONS-Hepatitis B vaccines are generally well tolerated. About IO % to 15% of recipients report soreness at the injection site. Rarely, immediate or delayed hypersensitivity (allergic reactions) have been reported. In general, virus vaccines are not given to pregnant women unless specifically indicated. However, studies indicate that the vaccine is safe in pregnancy.

HEPATITIS B FACTS

What is Hepatitis B?

Hepatitis B is an infection of the liver caused by the hepatitis B virus. Safe, effective vaccines are available to prevent hepatitis B infection. In addition, there are four other types of hepatitis, and researchers are working on vaccines for them.

Generally, the highest risk of hepatitis B infection is associated with occupations, lifestyles, or environments in which there is frequent contact with blood or blood products from infected persons. Hepatitis B often is spread by contaminated needles and sexual contact. Some persons who are infected with hepatitis B become chronic carriers, which means that the hepatitis B virus is in their blood for more than 6 months and they may spread the infection to others for a long period of time.

Hepatitis B carriers may develop chronic hepatitis, which can lead to cirrhosis of the liver and death due to liver failure. In addition, chronic hepatitis B carriers are more likely than others to get liver cancer.

What are the symptoms of acute Hepatitis B?

Hepatitis B has an incubation period averaging 60 to 120 days. Acute hepatitis B generally begins with mild symptoms that may or may not become severe. These symptoms may include loss of appetite, extreme tiredness, nausea, vomiting, stomach pain, dark urine, and jaundice. Skin rashes and joint pain can also occur.

Is Hepatitis B preventable?

Yes, hepatitis B is preventable in several ways. Since 1982 there has been a safe and effective hepatitis B vaccine. The current vaccine is a noninfectious viral vaccine derived from hepatitis B surface antigens produced in yeast cells. The vaccine is usually given in three doses: the second dose is given 1 month after the initial injection, and the third is given 6 months after the first. It is important to receive all three doses for optimal protection.

Who should receive the vaccine?

The hepatitis B vaccine is recommended for babies, children, and all adolescents and young adults who have not been previously vaccinated. Persons at high risk of infection include health care workers, clients and staff of institutions for the mentally retarded, hemodialysis patients, sexually active persons, and household and sexual contacts of HBV carriers. Many parts of the world have a high rate of infection that results in transmission from mothers to their newborn infants, who then become carriers. As a result, Alaskan natives, native Pacific Islanders, and immigrants and refugees from eastern Asia and sub-Saharan Africa are at risk for chronic hepatitis B infection.

All pregnant women should have a blood test to determine if they are HBV carriers. If a mother tests positive for hepatitis B, her infant should receive hepatitis B immune globulin at birth and start the hepatitis vaccine series.

Where can I get more information?
Call Student Health Services or your local County Health Department.

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