Download Management of Hazardous Materials

Chapter 10
Management of Hazardous
Material
Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED.
1
OSHA’s Objective
• To provide a safe work environment for all
employees
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Bloodborne/Hazardous
Materials Standard
• Methods of compliance
– Standard precautions
– Engineering and work practice controls
– PPE
– Housekeeping
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Standard Precautions
• All human blood and OPIM are considered
infectious.
• The same precautions must be taken with
all of the following:
– Blood
– Saliva
– Tissue
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Universal Precautions
• Treat and prepare as if each patient has a
potentially infectious disease
– Hepatitis B virus (HBV)
– Hepatitis C virus (HCV)
– Human immunodeficiency virus (HIV)
• Achieved through engineering and work
practice control standards
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Hazard Communication
Standard
• Employee “right to know” law
– Employees have the right and need to know
the identity and health hazards of the
chemicals they use in a dental office.
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Hazard Communication Program
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Employee training
Chemical inventory record
Safety measures for handling of chemicals
Product MSDS sheets
Labeling of chemical containers
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Employee Training
• Required for all employees with
occupational exposure
– On hire
– Annually
– On introduction of new procedure or product
• Must be interactive
– Followed by question and answer session
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Training Records
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Date of training
Summary of training
Name and qualifications of trainer
Name and job title of attendees
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Hepatitis B Vaccine
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Recommended for all healthcare providers
Provided within 10 days of hire
Provided at no cost to employee
If employee refuses, then waiver must be
signed
– Made available if employee changes mind
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Administering Vaccination
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Administered in a series of three injections
Scheduled at 0,1, and 6 months
Injection given in arm (deltoid muscle)
Commonly used vaccines
– Recombivax HB
– Engerix-B
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11
Components of Exposure
Control Plan
• A written plan for occupational exposure
• Written policies and procedures for
complying with the standard
• Reference guide for policies and
procedures
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Occuptaional Exposure
Determination
• Employees list tasks and identify category
of risk
Exposure Control Plan
Job Classifications
Category One
Category Two
Exposure to blood,
Occasional exposure
saliva, and body tissue
Category Three
No exposure
Dentist
Coordinating assistant
Accountants
Hygienist
Receptionist
Insurance processor
Assistant
Laboratory technician
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Occupational Exposure
• Contact with blood or OPIM through any of
the following:
– Eyes
– Skin
– Mucous membranes
– Parenteral piercing of membranes by any of
the following:
• Needle stick
• Cuts
• Abrasions
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Occupational Exposure
Incident
• Employee exposed to infectious material
– Report it immediately
– Receive medical evaluation and follow-up
examination
– Identify the route of exposure
– Identify the source patient
– Request that source patient be tested
– Employee has the right to refuse testing
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Post-Exposure Plan
• Counseling
• Prophylaxis treatment
– Injections of gamma-globulin
– Tetanus
– HBV vaccine booster
– Education of preventing sexual transmission
• Employer not responsible for costs
associated with treatment of disease
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Employee Medical Records
• Records kept throughout employment plus
30 years
• Remain confidential
• Records include the following:
– Vaccination status
– Post-exposure follow-up evaluation
– Healthcare professional’s written opinions
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Material Safety Data Sheets
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Identifies chemicals in product
States health and safety information
Provided by manufacturer
One copy for each dental product
Stored in notebook with easy reference
guide
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Chemical Warning Labels
• Developed by the National Fire Protection
Agency
• Warns employees using chemicals about
hazards
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Methods of Minimizing Aerosols
• Place lids on ultrasonic cleaner
• Do not spray chemicals
– Saturate paper towels, then wipe
• Use HVE suction
• Apply rubber dam
• Wear masks and protective eyewear
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Ways in which Chemicals
Enter the Body
• Inhalation
• Ingestion
• Skin
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Engineering/Work Practice
Controls
• The physical equipment and mechanical
devices employers provide to safeguard
and protect employees
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Examples of Engineering
Controls
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Splash guards on model trimmers
Sharps containers near place of use
Ventilation hood
Eye wash station
Sterilizers and ultrasonic cleaners
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Eye Wash Station
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Examples of Sharps
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Needles
Syringes
Surgical blades
Endodontic files
Burs
Carpules contaminated with blood
Broken glass
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Sharps Container
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Red
Biohazard label
Puncture-resistant
Leak-proof
Sealed lid
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Sharps Injury Protection
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Use self-sheathing needle system
Use needle guards
Never recap needle with two hands
Use one-handed scoop method to recap
Dispose of sharps in sharps container
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Workplace Controls
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Wash hands after removing gloves
Do not recap needles without guard
Do not eat or drink in work area
Food and drink should be stored away
from work area
• Do not wear laboratory coat out of office
• Remove laboratory coat before eating
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Personal Protective Equipment
• Includes eye protection, gloves, masks,
and protective clothing
• Provided by employer at no cost to
employee
• Stored at work site
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Eyewear
• Wear safety glasses with solid side
shields.
• Prescription glasses can be fitted with side
shields.
• Face shields may be worn over glasses.
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Gloves
• Must be worn when in contact with OPIM
• Vinyl and latex are for general use
• Utility gloves are for the following:
– Surface disinfection
– Handling sharps
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Masks
• Prevents inhalation of infectious aerosols
• Changed after each patient or when damp
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Protective Clothing
• Prevents contamination of the skin and
clothes
– Scrub jacket
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Fluid resistance
Sealed cuffs
Lap protection
High collar
Daily changes
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Laundry
• Laboratory coats stored in leak-proof
container with a biohazard label
• Laundry options
– Professionally laundered
– Laundered at office
– Laundered at dentist’s home
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Housekeeping
• Written schedule for cleaning and
decontaminating worksite
• Contaminated work surfaces immediately
cleaned
• Policy for cleaning equipment
• Barriers replaced after each use
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Hazardous Waste
• Maintain chemical inventory sheet
• Hire hazardous waste hauler
– Fixer
– X-ray foil
– Amalgam scrap
– Vapo-sterile solution
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Solid Waste
• Items contaminated with body fluids that
do not drip blood when squeezed
– Gloves
– Gauze
– Cotton rolls
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Disposal of Solid Waste
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Label container with red biohazard sticker
Handle with gloves
Line waste container with plastic liner
Dispose according to local regulations
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Regulated Medical Waste
• Includes items that drip with blood
– Dressings
– Gauze
– Tissue
– Sharps
• Discarded by hazardous waste hauler
• Must be removed from office on schedule
according to amount of waste generated
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Regulated Medical Waste
Container
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Leak-proof
Labeled biohazard waste
Color-coded red or orange
Closable lid
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Extracted Teeth
• Those that have been disinfected/sterilized
are considered noninfectious waste and
may be disposed.
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