OREGON ELAW

  • BLOOD BORNE PATHOGENS 4.4
    4.4.1 PURPOSE

    A. Exposure to blood borne pathogens may lead to sickness such as Hepatitis B Virus (HBV), Hepatitis C Virus (HCV), Human Immunodeficiency Virus (HIV) that causes AIDS, and more than twenty other potential infections. The purposes of this procedure are:

    1. To provide appropriate safeguards for members who may be exposed to blood borne pathogens.

    2. To provide a source of reference for Department members in the use of the equipment provided for protection against exposure to blood borne pathogens.

    3. To establish an inventory and inspection procedure to ensure that
     protective equipment is available and not contaminated.

    4. To establish minimum standards for training of all members who perform tasks that place them in a risk exposure category.

    5. To establish procedures to be followed when a member is exposed to the bodily fluids of another person.

    4.4.2 EXPOSURE CATEGORIES

    A. All sworn members, Police Technicians and Criminalists are considered to be in Exposure Category I. Category I exposure is defined as all job classifications in which all members in those job classifications have occupational exposure.

    • Community Safety Specialists and Police Record Specialists are considered to be in Exposure Category II. Category II exposure is defined as all job classifications where normal work routinely requires no exposure to blood, body fluids or tissues, but may involve unplanned Category I tasks such as dealing with assaultive individuals.
    C. Other members of the Department are considered to be in Exposure
    Category III. Category III exposure is defined as all job classifications
    where members are not called upon as part of their employment to perform or assist in high-risk exposure situations.

    4.4.3 UNIVERSAL HEALTH PRECAUTIONS AND WORK PRACTICES

    A. As recommended by public health authorities, the Department will adhere to a program of Universal Precautions for protection against diseases spread by blood or bodily fluids (“bodily fluids” refers to fluids that may contain blood, blood products, semen, amniotic fluid, fluid surrounding the heart and lungs, or vaginal secretions but NOT feces, urine, sweat, saliva, vomitus, or tears). In addition, HBV and HCV can live up to 7 days in dried bodily fluid and shall be considered infectious.

    B. For safety purpose, members will operate on the assumption that ALL blood and bodily fluids are potential carriers of blood borne diseases and will adhere to Universal Precautions to protect against AIDS and other diseases. These outlined general precautions will be followed:

     1. Eating, drinking, smoking, applying cosmetics, lip balm or handling contact lenses are prohibited in the work areas, including field locations, where there is an anticipated exposure to blood borne pathogens.

     2. The Oregon Administrative Rules mandate Universal Precautions at all times to prevent contact with blood or other potentially infectious materials. It is difficult or impossible to differentiate between bodily fluid types under circumstances present in the workplace. Therefore, ALL BODILY FLUIDS AND DRIED RESIDUE SHALL BE CONSIDERED POTENTIALLY INFECTIOUS MATERIAL, including blood and tissue or organs from either a living or dead human.

     3. Any member rendering medical assistance that may expose them to blood or bodily fluids will take precautions against contamination (such as wearing Personal Protective Equipment (PPE): i.e., latex gloves while bandaging a bleeding wound or using a disposable mouth piece for CPR). A member exposed to blood or bodily fluids will, as soon as possible:

     a. Remove rings, watches and all other jewelry in the exposed area.

     b. If exposure is to a member in the field, wash the exposed area(s) with an approved waterless cleaner.

    c. In all cases and as soon as possible, thoroughly scrub the exposed area(s) with soap and water.

    4. Contact with non-intact skin, mucous membranes or piercing the skin barrier through such events as needlesticks, human bites, cuts and abrasions shall be immediately washed with soap and running water.

    4.4.4 SAFEGUARD – PERSONAL PROTECTIVE EQUIPMENT (PPE)

    A. The following items of equipment will be available to Department members:

     1. Gloves in sizes large and medium, laerdal pocket masks, needle sharps containers, protective eye wear, waterless cleaner, Biosafe hand lotion. BIOHAZARD bags and BIOHAZARD labels are located in one or all of the following locations:

     a. The report writing room.

     b. The DUII processing room.

     c. The storage room between Administration and Investigations.

     d. Blue boxes in the trunks of all Department vehicles.

     2. Face shields and protective clothing are located in the crime lab and property rooms.

     3. Additional BIOHAZARD warning labels and bags may be obtained from the Administrative Sergeant, Criminalist, Senior Police Technician and Police Technician or from the storage room between Administration and Investigations.

    B. It shall be the responsibility of individual members to verify that items of Personal Protective Equipment are readily available during the normal vehicle check at the beginning of the shift. If the heat sealed plastic bag has been opened, members should exchange it for a sealed container through the duty supervisor.

    C. Large sharps containers are available from the Gresham Fire Department.

    4.4.5 CRIMINAL INVESTIGATIONS AND SPECIFIC SAFETY PRECAUTIONS

    A. Crime Scene Processing

     1. Wear appropriate PPE (i.e., protective gloves and clothing) as necessary to prevent direct contact with blood and bodily fluids. NOTE: The use of gloves does not eliminate the need for hand hygiene. Upon removing gloves wash hands with an approved alcohol-based hand rub.

    2. Utilize proper evidence collection techniques and exercise extreme care when searching hidden areas, such as in dresser drawers, pockets, and any area that cannot be directly seen while searching.

    3. Refrain from eating, drinking, smoking or applying makeup at any contaminated scene. Also, be careful to keep hands away from face, especially the mouth and eyes when handling evidence or when in contact with fluids.

    B. Identification of Contaminated Material

    1. Red plastic bags labeled “BIOHAZARD” shall be used to contain dry contaminated material until proper disposal.

    2. Paper bags, affixed with a BIOHAZARD label, shall be used to contain wet contaminated material and all blood (wet or dry).

    3. BIOHAZARD labels shall be fluorescent orange or orange-red or predominantly so, with lettering or symbols in a contrasting color.

    4. Warning labels shall be conspicuously posted on evidence, vehicles, clothing, storage containers and facilities (i.e., sharps containers, refrigerators, freezers) of potentially infectious materials.

    C. Disposal

    1. Decontamination and disposal of contaminated equipment and material will be done by the Gresham Fire Department.

    2. Contaminated equipment and material will be placed in a red plastic bag, labeled for decontamination and taken to “the clean room” at Gresham Fire Station #71.

    3. Needles, syringes and other sharps will be placed in a sharps container. If they are to be retained as evidence, the sharps container will be handled as evidence. Syringes, needles and other sharps that are not to be retained as evidence will be placed in a sharps container and taken to “the clean room” at Gresham Fire Station #71 for disposal by the Fire Department.

    4. Patrol vehicles that become contaminated with bodily fluids will be immediately downed and a vehicle maintenance request forwarded to the Administrative Sergeant. The Administrative Sergeant will ensure that the vehicle is processed for decontamination.

    5. Uniforms that become contaminated with bodily fluids will be placed in a red plastic bag, labeled for decontamination and taken by the officer to the dry cleaners.

    4.4.6 DEATH SCENE PROCESSING

    A. Wear appropriate PPE (i.e., protective gloves and clothing) as necessary to prevent direct contact with blood and bodily fluids.

    B. Prior to transporting a body suspected of being contaminated with an infectious disease, notify the receiving agency.

    C. Follow necessary decontamination procedures for personnel and the scene.

    4.4.7 EXPOSURE REPORTING PROTOCOL

    A. Blood borne pathogen information and reporting protocol packets are located in the Sergeant’s office and the Administration Forms file cabinet. Packets will include the most recent information pertaining to exposure reporting protocol, treatment procedures, exposure reports, communicable disease guidelines, and information on blood borne diseases.

    4.4.8 TESTING/COUNSELING/EVALUATIONS

    • Following a report of an exposure incident, Risk Management shall make immediately available to the exposed employee, at no cost to the employee, a confidential medical evaluation and followup investigated by or under the supervision of specially trained licensed healthcare professionals. Tualatin Valley Fire & Rescue Exposure Service oversees this medical evaluation and followup process. Contact TVFR Exposure Service, (503) 721-0529 immediately, 24 hours per day. Follow instructions given by the licensed healthcare professional.

    • The medical evaluation and followup shall include documentation of routine exposure; circumstances under which the exposure incident occurred; identification and documentation of the source individual following Oregon law, unless it can be established that identification is not feasible.


    • The source individual's blood shall be tested in order to determine HBV, HCV, and HIV infection as soon as feasible and after consent is obtained.


      • Since consent is not required for HBsAg (Hepatitis B surface Antigen) or HCV (Hepatitis C Virus) by Oregon law, the source individual's blood, if available, shall be tested and the results documented.


      • Informed consent from the source individual shall be obtained for HIV testing (Oregon law requires informed consent for HIV testing).


    3. If informed consent is     not obtained, Exposure Control Officer shall establish that legally required informed consent could not be obtained. If HIV testing of source is deemed necessary for medical intervention, OAR 333-012-0269 “Procedures for Mandatory HIV Testing Following Occupational Exposure to Body Fluids” http://arcweb.sos.state.or.us/rules/OARs_300/OAR_333/333_012.html may be activated.

    4. Oregon Administrative Rule 3330120264 requires that "a physician may notify an individual who has had a parenteral or mucosal exposure to blood or other body fluids from another individual whether that individual had been HIV tested, and if so, what the test results were, provided that: (1) the individual whose HIV test information released is notified in writing of this disclosure, and (2) the identity of the HIV tested person is not explicitly disclosed during the notification process.”


    D. Results of the source individual's testing shall be made available to the exposed employee, and the employee shall be informed of applicable laws and regulations concerning disclosure of the identity and infectious status of the source individual.

    E. The exposed employee's blood shall be collected as soon as feasible and tested after consent is obtained.

    1. 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.

    2. 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 prophylaxis shall be made available when medically indicated and as recommended by the U.S. Public Health Service.

    • Counseling and the evaluation of any reported illnesses shall be made available to the exposed employee through a qualified healthcare professional from the Tualatin Valley Fire & Rescue Exposure Service. To assist the healthcare professional who is evaluating an employee after an exposure incident, the following information is provided:

    1. A copy of the Exposure Control Plan.

    2. A description of the exposed employee's duties as they relate to the exposure incident.
    3. Documentation of the route of exposure and circumstances under which exposure occurred.

    4. Date and time of incident.

    5. Results of the source individual's blood testing, if available.

    6. All medical records relevant to the appropriate treatment of the employee including vaccination status.

    H. After consultation, the healthcare professional will provide the employee with a copy of the evaluating healthcare professional's written opinion within 15 days of the completion of the evaluation containing the following information:

    1. Whether Hepatitis B vaccination is recommended for the employee, and if the employee has received the vaccination.

    2. Confirmation that the employee has been informed of the results of the evaluation.

    • Confirmation that the employee has been told about any medical conditions resulting from exposure to blood or other potentially infectious materials which require further evaluation or treatment.

    4. All other findings or diagnosis shall remain confidential and shall     not be included in the written report.


    4.4.9 RECORD KEEPING


    A. The Training Unit shall maintain records that document the training and
    indicate the dates of the training sessions, the content and length of the
    training and names of the instructors and members who receive the training.

    B. The City Risk Manager will maintain records of instances of member
    exposure including medical information and follow-up. These records will
    be kept confidential and will not be discussed or reported without the member’s express written consent, except as required by law.

    C. The City Risk Manager (Exposure Control Officer) will oversee the implementation of an approved exposure program. The TVRF Exposure Program shall be responsible for setting up the system and maintaining the records. The system will include the following information:

    1. Name and Social Security number of the employee.

    2. A copy of the employee’s Hepatitis A & B vaccination and Tuberculosis testing status including the dates of all the Hepatitis vaccinations and any medical records relative to the employee’s ability to receive vaccination.

    3. Copies of the results of the examinations, medical testing and follow-up procedures that took place as a result of an employee’s exposure to Blood Borne/Airborne Pathogens.

    4. A copy of the information provided to the consulting healthcare professional as a result of any exposure to Blood Borne/Airborne Pathogens.

    5. The above information, as all information in these areas, shall be kept confidential and not disclosed or reported without the employee’s express written consent to any person within or outside the workplace except as required by law.

    6. TVFR Exposure Service shall maintain the required records for at least the duration of employment plus 30 years.


    4.4.10 TRAINING


    A. The Training Unit of the Services Division shall coordinate an initial training program followed by annual refresher courses, as required by DPSST, for all Department members. Training shall include but not be limited to the following areas:

    1. Modes of transmission of HBV, HCV and HIV.

     2. Equipment available for protection.

     3. The location of protective equipment, how to use it, and how to remove, handle, decontaminate and dispose of contaminated equipment.

     4. Limitations of protective equipment.

     5. Education regarding where to seek treatment, actions to be taken, and the appropriate reporting procedures in event of exposure.

     6. Education about the effects of blood borne pathogens.

    4.4.11 HEPATITIS B VACCINATION INFORMATION


    A. All members who have a reasonably anticipated occupational exposure to Hepatitis B shall be offered the opportunity to receive the Hepatitis B vaccination series and any boosters as recommended by law. Receiving the Hepatitis B series is not mandatory, nor is it a bonafide occupational qualification.
    B. Antibody testing shall be performed on all vaccination recipients to determine that the member is immune to Hepatitis B, or that the vaccine is contraindicated for medical reasons.

    C. A member may initially decline to receive the Hepatitis B series, and later decide to receive the series. The vaccination series can be provided at any time the member performs duties where there is a reasonably anticipated occupational exposure to Hepatitis B.

    D. If any member declines to receive the Hepatitis B vaccination series, the member MUST sign a statement indicating the declination. The statement of declination will be maintained in the Risk Management files, with a copy maintained in the Training Unit files.

    E. The Training Unit shall maintain copies of records that document vaccination or statement of declination, date, and member receiving or declining the Hepatitis B vaccination series.




    Carla C. Piluso
     Chief of Police

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