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Medical/Infectious/Regulated Waste Operations: Although OSHA is not aware of any documented cases of HBV or HIV infection associated with the collection, transportation, and final disposal of "regulated" waste, About Crime Scene Cleanup Companies In California the potential for such an infection prior to final disposal of the waste is clear. 

The situation facing employees who handle "regulated" waste within healthcare and other facilities was  described by Judith Gordon, testifying as an expert witness for OSHA. About Crime Scene Cleanup Companies In California She stated: At many work sites, concern for  employee safety and health is directed primarily toward the professional and skilled workers, and the impact of work practices on the safety and health of the maintenance and janitorial staff is often overlooked. 

Yet, if the exposure to bloodborne pathogens that are present on blood-contaminated items constitutes an occupational hazard to, for example, About Crime Scene Cleanup Companies In California the healthcare worker, it poses the same risk for the person who must handle the same blood-contaminated items when they are waste. 

Scientifically and logically, handlers of infectious waste are also at risk of occupational exposure to bloodborne pathogens. About Crime Scene Cleanup Companies In California Infectious waste management has many aspects including discard of the infectious waste, its collection and storage, and treatment of the waste before disposal. Each of these activities has an inherent risk of occupational exposure to bloodborne pathogens. 

The work practices of those who initially discard infectious waste have a direct effect on the potential for exposure and the risks faced by those employees downstream who handle the infectious waste. About Crime Scene Cleanup Companies In California Browning-Ferris Industries (BFI) described the types of occupational exposure that may occur after the employee of the medical waste company has picked up the medical ("regulated") waste. 

BFI's medical waste employees perform a variety of tasks associated with transporting and disposing of medical waste. Unlike healthcare and medical laboratory workers who may be exposed to bloodborne pathogens through direct and indirect patient contact, specimen collection and processing, About Crime Scene Cleanup Companies In California or handling dressing, linens, waste. 

Medical equipment, BFI medical waste employees handle waste only after it has been packaged and/or placed in a plastic container (tub) for transport and disposal. Medical waste workers load packages for transport, off load packages and tubs at transfer stations and destination facilities, About Crime Scene Cleanup Companies In California prepare packages and tubs for treatment or destruction, and operate equipment which moves waste into and through treatment or destruction processes. 

BFI's assessment is that the greatest potential occupational exposure of our employees to bloodborne pathogens is through needle sticks from sharps not properly packaged by generators in rigid containers, About Crime Scene Cleanup Companies In California or from sharps containers not properly sealed. 

Medical waste workers are also exposed through improperly packaged fluids, and through spill response activities. About Crime Scene Cleanup Companies In California BFI's own packaging and handling practices, including reliance on mechanical waste handling, as well as state and federal packaging requirements, substantially reduce these exposure routes.  

These comments clearly indicate the nature of the occupational exposure of employees who have contact with regulated waste from its generation to its ultimate disposal. About Crime Scene Cleanup Companies In California Equipment Service and Repair: Several commenters pointed out the potential risk to employees who service.

Repair medical instruments or other types of equipment contaminated with blood or body fluids such as dialysis pumps, About Crime Scene Cleanup Companies In California pacemakers, liquid chromatographs, and centrifuges. These devices are often contaminated both externally and internally. 

This hazard may be encountered when the equipment is serviced on site or at the factory or service center prior to decontamination Dr. Amiram Daniel, testifying on behalf of the Health Industry Manufacturers Association, described how employees who sell and service medical equipment may be exposed. About Crime Scene Cleanup Companies In California He stated: In our industry we employee about 200,000 workers. 

About 10% of these workers are engaged in labor which may put them in contact with potentially infectious material. About Crime Scene Cleanup Companies In California Our field force, composed of sales, service and repair, quality assurance and teaching personnel, must come in contact with the patient in the hospital, clinic or home environment, or with contaminated devices. 

Some of our used products are returned to the manufacturer for a variety of reasons -- replacements and failure investigation to mention but two. About Crime Scene Cleanup Companies In California The manufacturing personnel handling these shipments do not always know the status of the devices, who used them and how, whether they were disinfected prior to shipping, etc. 

One group opposed coverage of these employees. Mr. Timothy Fise, representing the American Dental Trade Association (ADTA), About Crime Scene Cleanup Companies In California testified that it was the opinion of the ADTA that medical and dental companies that engage in equipment repair should be excluded from the standard because they contend that the risk of infection is remote. 

Mr. Fise stated: Companies do these repairs either: (1) outside of the medical/dental facility, or (2) at a time substantially after the equipment was in use with exposure to any patient. About Crime Scene Cleanup Companies In California With the likelihood that equipment is incapacitated for at least several hours (if done on-site).

More likely several days before repair (if the equipment is shipped to the medical/dental facility for repair) any HBV which may have been present on the equipment will long since have died, and the exposure/risk eliminated. About Crime Scene Cleanup Companies In California As noted above, any risk was remote at worst (Mr. Timothy Fise, ADTA, Ex. 65). 

This argument, that blood contaminated equipment does not present a hazard was addressed in the opening paragraphs of this section. About Crime Scene Cleanup Companies In California It is well documented that HBV can remain viable on environmental surfaces for at least a week.

Transmission of HBV infection from exposure to contaminated environmental surfaces has been documented to be a major mode of spread in certain settings, About Crime Scene Cleanup Companies In California particularly hemodialysis units (Exs. 6-56; 6-440; 6-461; 6-480). Public Safety and Emergency Medical Services: 

Other employees who may be exposed to blood and other potentially infectious materials include emergency medical service providers, firefighters, law enforcement personnel and correctional officers. About Crime Scene Cleanup Companies In California These employees would be covered under the final standard if they have actual.

Potential occupational exposure to blood or other body fluids and if they are employed by the private sector, the federal government, or a state or local government in a state that has an OSHA-approved state plan. About Crime Scene Cleanup Companies In California Employees of state and local governments, including those employed in public hospitals. 

Health clinics, in states without state occupational safety and health plans are not covered by OSHA regulations. About Crime Scene Cleanup Companies In California (For more information on states and territories with OSHA state plans, see Section II: Legal Authority) Finally, the Congress has expressly indicated that OSHA is to protect healthcare and public safety workers from HIV and HBV. 

The Congress mandated CDC to develop guidelines for protecting healthcare and public safety workers from HIV and HBV About Crime Scene Cleanup Companies In California and to submit the guidelines to OSHA for its use in the development of this standard. 

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