Bloodborne Standard
29 CFR 1910.1030
Post-Exposure and Follow-Up
After a report of an incident of exposure, the employer will immediately make available a confidential medical evaluation and follow-up to the employee that includes, at the least, the following elements:
1. Documentation of the route(s) of exposure, and the circumstances under which the exposure incident occurred.
2. Identification and documentation of the source individual, unless the employer can establish that identification is impractical or prohibited by state or local law. North Carolina statues require the source individual be tested. When the source individual is already known to be positive for HIV or HBV, the test does not need to be repeated. Results of tests are to be made available to the exposed employee, but he or she must be made aware of confidentiality requirements.
3. Collection and testing of the exposed employee's blood for HBV and HIV serological status, which means finding out if the virus is already present in the employee's blood. Collection must take place as soon as possible after the exposure incident to provide a baseline for diagnosis. Consent must be obtained from the employee prior to testing. If the employee refuses consent, the sample must be kept for at least 90 days to allow the employee to provide consent. as soon as consent is obtained, the sample must be tested. If the employee does not give consent, this should be documented. Current Centers for Disease Control(CDC), recommendations include testing the employee for evidence that the HIV is present in the blood at six-week, twelve-week, and six-month intervals if the source individual is HIV positive and if the employee's baseline test is negative.
4. Post-exposure prophylaxis, when medically indicated as recommended by the CDC.
5. Counseling: The employer must provide counseling about both the exposure incident and the medical follow-up, and must also provide psychological counseling if it is recommended by the healthcare professional.
6. Evaluation of reported illnesses: The exposed employee should be instructed to report and seek medical evaluation for any acute illness or any illness with a fever that occurs during the follow-up period. Following the post-exposure follow-up, the health care professional must provide the employer a written opinion including whether the hepatitis B vaccine is indicated and whether the employee received such vaccination. An opinion of what post-exposure evaluation and follow-up is needed. The employer must obtain this report and give a copy to the employee with in fifteen days after the evaluation is completed. All other findings or diagnoses must remain confidential and cannot be included in the written report. This provision of confidentiality may become a problem in small medical or dental offices where the employer serves as the health care professional for the employees. Using a physician outside the workplace is recommended in such situations. This report must note that the employee has been informed of the results of the evaluation and that the employee has been told of any medical conditions resulting from exposure to blood or other potentially infectious materials that require further evaluation or treatment.
If you have any questions at any time regarding the information presented in this tutorial, please contact David Sullivan at 910-916-0688.
(North Carolina Department of Labor (2010). A guide to bloodborne pathogens in the workplace.)