This plan is designed to eliminate or minimize exposure to blood borne pathogens, as well as define reporting and follow-up procedures in case of an exposure incident.   This plan refers to OSHA’s (Occupational Safety and Health Administration) blood borne pathogens standard. 

Definitions

Blood borne pathogens:  Refers to infectious materials in blood that can cause disease in humans.  This includes hepatitis B (HBV) and C and human immunodeficiency virus (HIV). 

Exposure:  The most obvious exposure incident is a needle stick, however any specific eye, mouth, other mucous membrane, non-intact skin, or contact with blood or other potentially infectious material is considered an exposure incident.

Prevention of Exposure Incident

Universal Precautions, Taken form 2003-2003 NCAA Sports Medicine Handbook, 16th edition, August 2003, page 39.

The following recommendations are designed to further minimize risk of blood borne pathogen transmission in the context of athletic events and to provide treatment guidelines for caregivers.  These are sometimes referred to as “universal precautions”, but some additions and modifications have been made as relevant to the athletics arena.

1. Pre-event preparation includes proper care for wounds, abrasions, cuts or weeping wounds that may serve as a source of bleeding or as a port of entry for blood borne pathogens.  These wounds should be covered with an occlusive dressing that will withstand the demands of competition.  Likewise, care providers with healing wounds or dermatitis should have these adequately covered to prevent transmission to or from a participant.  Student-athletes may be advised to wear more protective equipment on high-risk areas, such as elbows and hands. 
2. The necessary equipment and/or supplies important for compliance with universal precautions should be available to caregivers.  These supplies include appropriate gloves, disinfectant bleach, antiseptics, designated receptacles for soiled equipment and uniforms, bandages and/or dressings and a container for appropriate disposal of needles, syringes, scalpels, and other sharps materials.
   
1. Preventative practice includes, use of gloves and other protective equipment such as one-way valve masks. 
2. Appropriate procedures for hand washing, sharps disposal, glove and biohazard disposal, contaminated laundry handling and material cleaning should also be practiced to reduce the likelihood of exposure.
3. When a student-athlete is bleeding, the bleeding must be stopped and the open wound covered with a dressing sturdy enough to withstand the demands of activity before the student-athlete may continue participation in practice or competition.  Current NCAA policy mandates the immediate, aggressive treatment of open wounds or be removed from the event as soon as is practical.  Return to play is determined by appropriate medical staff personnel.  Any participant whose uniform is saturated with blood, regardless of the source, must have that uniform evaluated by appropriate medical personnel for potential infectivity and changed if necessary before return to participation. 
4. During an event, early recognition of uncontrolled bleeding is the responsibility of officials, student athletes, coaches and medical personnel.
5. Personnel managing an acute blood exposure must follow the guidelines for universal precautions.  Sterile latex gloves should be worn for direct contact with blood or body fluids containing blood.  Gloves should be changed after treating each individual participant and, after glove removal hands should be washed.
6. Any surface contaminated with spilled blood should be cleaned in accordance with the following procedures:  With gloves on, the spill should be contained in as small an area as possible.  After the blood is removed, the surface area of concern should be cleaned with an appropriate decontaminant.
7. Proper disposal procedures should be practices to prevent injuries caused by needles, scalpels and other sharp instruments or devices.
8. After each practice or game, any equipment or uniforms soiled with blood should be handled and laundered in accordance with hygienic methods normally used for treatment of any soiled equipment or clothing before subsequent use.  This includes provisions for bagging the soiled items in a manner to prevent secondary contamination of other items or personnel. 
9. Finally, all personnel involved with sports should be trained in basic first aid and infection control.

OSHA protocol and standards shall be reviewed yearly with athletic training students. 

REPORTING AN EXPOSURE INCIDENT

EMPLOYEES OF THE UNIVERSITY
 In the event of an exposure incident, please inform the Head Athletic Trainer.  Follow appropriate workers compensation guidelines including:

1. Complete the employee injury report immediately.
2. If medical treatment is required, contact 1-800-624-2354 to seek authorized medical care.  Treatment not authorized will be at your own expense.  (All exposure incidents should be medically treated)
3. Complete the Authorization to Release Medical Records form granting access to medical records.  These records must be received before payment of medical charges may be considered.

RETURN ALL FORMS TO YOUR EMPLOYER PROMPTLY.  FALIURE TO COMPLETE THESE FORMS MAY DELAY CONSIDERATION OF WORKERS’ COMPENSATION BENEFITS.
Questions or concerns may be directed to the Central Accident Reporting Office (CARO) at (573)751-2837 or 1-888-622-7694.

ATHLETIC TRAINING STUDENTS
In the event of an exposure incident, students should report the incident to the supervising Certified Athletic Trainer immediately. 

• Student will be sent immediately to Student Wellness, ext. 2348 for evaluation and testing.  Treatment will be based on recommendations of medical personnel.
• Any questions or concerns may be addressed to Center for Health Counseling, 651-2270, contact Sallie Loos, R.N.
• Written documentation of the incident as soon as feasible following the exposure. 
• Students: An exposure incident report should be used and properly filled out and returned to your supervising ATC. 
• Employees of the University:  Fill out an Employee Injury Report-Workers Compensation Form.

The Infected Athletic Trainer
An athletic trainer infected with a blood borne pathogen should practice the profession of athletic training taking into account all professionally, medically, and legally relevant issues raised by the infection. Depending on individual circumstances, the infected athletic trainer will or may wish to:

• Seek medical care and on-going evaluation
• Take reasonable steps to avoid potential and identifiable risks to his or her own health and the health of his or her patients.
• Inform, as or when appropriate, relevant patients, administrators, or medical personnel

Post-Exposure Follow Up
Follow up care will be based upon recommendation by medical personnel treating exposure. 
Follow up care includes:

• Laboratory tests, confidential medical evaluation, identifying and testing the source of the individual (if feasible), testing the exposed employee’s blood, performing post-exposure prophylaxis, future screenings, preventative medicines, offering counseling, and evaluating reported illnesses.
• ALL DIAGNOSIS AND MEDICAL RECORDS SHALL REMAIN CONFIDENTIAL

PROPER DISPOSAL OF CONTAMINATED MATERIAL

Material that has been contaminated should be disposed in properly marked Biohazard containers as soon as possible after use.  Sharps materials, i.e. needles, scalpels, lancets, etc., should be disposed of in a container explicitly designed for that purpose.

REMOVAL AND DISPOSAL OF CONTAMINATED WASTE MATERIAL

A designated person(s) will supervise marked Biohazard and Sharps containers.  When full, the biohazard bag will need to be properly closed and Sharps containers properly sealed, then taken to the Microbiology Dept. in Rhodes Hall, 3rd floor. 

Address questions to Risk Management at 986-6840, or the Biology Dept. at 651-2170.

HBV VACCINATIONS

As part of OSHA’s blood borne pathogens regulations, Southeast Missouri State University employees are eligible to receive the Hepatitis B vaccine and vaccination series.

OSHA regulations however, do not cover students who are not employees of the University.  This includes students who are accepted into or who are applying to the Athletic Training Education Program.  HBV Vaccinations are strongly recommended and encouraged for all individuals who risk exposure to blood born pathogens.  Please note that the cost of this inoculation is NOT covered by the Department of Intercollegiate Athletics or the Athletic Training Education Program.  Southeast Missouri State University Student Health Services is available to administer this vaccination series, or it may be obtained from your family physician.  If the athletic training student does not obtain this vaccination, a declination form must be signed.

Contact Numbers

Student Wellness	651-2348
Center for Health Counseling	651-2270
OSHA, http://www.osha.gov/	1-800-321-OSHA (6742)
Workman’s Compensation
Authorization for treatment	1-800-624-2354
CARO	314-751-2837
SEMO Human Resources, Diane Johnson, Benefits Specialist	573-651-2084
Risk Management	573-986-6840
St. Francis Medical Hospital, Corporate Health Services	331-5388
Biohazard Disposal, Biology Department 3rd floor Rhodes Hall	651-2170

Athletic Training Student Exposure Incident Report

This form should be filled out as soon as possible after incident.  In case of exposure incident the Athletic Training Student should inform their supervising Certified Athletic Trainer, and proper action should be taken, including being sent to Student Wellness for medical attention.
Please print clearly.

Athletic Training Student Name:_________________________________

1. Date of Exposure:___________________
2. Time of Exposure:___________________

3. Describe clearly and in detail how the incident occurred:

4. Certified Athletic Trainer incident was reported to:

5. Were there any witnesses to incident, if so, list names:

6. Did you seek medical attention at Student Wellness Center?

7. In your opinion, how might the injury be prevented or avoided in the future?

Athletic Training Student      Date

_______________________________    __________________

Certified Athletic Trainer      Date

_______________________________    __________________

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