1910.1030(f): Hepatitis B Vaccine and Exposure Follow-Up

(f) Hepatitis B vaccination and post-exposure evaluation and follow-up — 732 citations

(1) General. Open (f)(1) 228 citations

(i) The employer shall make available the hepatitis B vaccine and vaccination series to all employees who have occupational exposure, and post-exposure evaluation and follow-up to all employees who have had an exposure incident. Open (f)(1)(i) 209 citations

(ii) The employer shall ensure that all medical evaluations and procedures including the hepatitis B vaccine and vaccination series and post-exposure evaluation and follow-up, including prophylaxis, are: Open (f)(1)(ii) 19 citations

(A) Made available at no cost to the employee; 6 citations

(B) Made available to the employee at a reasonable time and place; 4 citations

(C) Performed by or under the supervision of a licensed physician or by or under the supervision of another licensed healthcare professional; and 1 citations

(D) Provided according to recommendations of the U.S. Public Health Service current at the time these evaluations and procedures take place, except as specified by this paragraph (f). Open (f)(1)(ii)(d) 6 citations

(iii) The employer shall ensure that all laboratory tests are conducted by an accredited laboratory at no cost to the employee.

(2) Hepatitis B Vaccination. Open (f)(2) 423 citations

(i) Hepatitis B vaccination shall be made available after the employee has received the training required in paragraph (g)(2)(vii)(I) and within 10 working days of initial assignment to all employees who have occupational exposure unless the employee has previously received the complete hepatitis B vaccination series, antibody testing has revealed that the employee is immune, or the vaccine is contraindicated for medical reasons. Open (f)(2)(i) 289 citations

(ii) The employer shall not make participation in a prescreening program a prerequisite for receiving hepatitis B vaccination. Open (f)(2)(ii)

(iii) If the employee initially declines hepatitis B vaccination but at a later date while still covered under the standard decides to accept the vaccination, the employer shall make available hepatitis B vaccination at that time. 1 citations

(iv) The employer shall assure that employees who decline to accept hepatitis B vaccination offered by the employer sign the statement in appendix A. Open (f)(2)(iv) 132 citations

(v) If a routine booster dose(s) of hepatitis B vaccine is recommended by the U.S. Public Health Service at a future date, such booster dose(s) shall be made available in accordance with section (f)(1)(ii). Open (f)(2)(v)

(3) Post-exposure Evaluation and Follow-up. Following a report of an exposure incident, the employer shall make immediately available to the exposed employee a confidential medical evaluation and follow-up, including at least the following elements: Open (f)(3) 48 citations

(i) Documentation of the route(s) of exposure, and the circumstances under which the exposure incident occurred; 2 citations

(ii) Identification and documentation of the source individual, unless the employer can establish that identification is infeasible or prohibited by state or local law; Open (f)(3)(ii) 16 citations

(A) The source individual's blood shall be tested as soon as feasible and after consent is obtained in order to determine HBV and HIV infectivity. If consent is not obtained, the employer shall establish that legally required consent cannot be obtained. When the source individual's consent is not required by law, the source individual's blood, if available, shall be tested and the results documented. Open (f)(3)(ii)(a) 9 citations

(B) When the source individual is already known to be infected with HBV or HIV, testing for the source individual's known HBV or HIV status need not be repeated.

(C) 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. 6 citations

(iii) Collection and testing of blood for HBV and HIV serological status; Open (f)(3)(iii) 5 citations

(A) The exposed employee's blood shall be collected as soon as feasible and tested after consent is obtained. Open (f)(3)(iii)(a) 3 citations

(B) 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. 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. Open (f)(3)(iii)(b) 2 citations

(iv) Post-exposure prophylaxis, when medically indicated, as recommended by the U.S. Public Health Service; 1 citations

(v) Counseling; and 1 citations

(vi) Evaluation of reported illnesses. 1 citations

(4) Information Provided to the Healthcare Professional. Open (f)(4) 15 citations

(i) The employer shall ensure that the healthcare professional responsible for the employee's Hepatitis B vaccination is provided a copy of this regulation. 1 citations

(ii) The employer shall ensure that the healthcare professional evaluating an employee after an exposure incident is provided the following information: Open (f)(4)(ii) 13 citations

(A) A copy of this regulation; 3 citations

(B) A description of the exposed employee's duties as they relate to the exposure incident; 1 citations

(C) Documentation of the route(s) of exposure and circumstances under which exposure occurred; 2 citations

(D) Results of the source individual's blood testing, if available; and

(E) All medical records relevant to the appropriate treatment of the employee including vaccination status which are the employer's responsibility to maintain. 2 citations

(5) Healthcare Professional's Written Opinion. The employer shall obtain and provide the employee with a copy of the evaluating healthcare professional's written opinion within 15 days of the completion of the evaluation. Open (f)(5) 17 citations

(i) The healthcare professional's written opinion for Hepatitis B vaccination shall be limited to whether Hepatitis B vaccination is indicated for an employee, and if the employee has received such vaccination.

(ii) The healthcare professional's written opinion for post-exposure evaluation and follow-up shall be limited to the following information:

(A) That the employee has been informed of the results of the evaluation; and

(B) 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. (iii) All other findings or diagnoses shall remain confidential and shall not be included in the written report.

(6) Medical recordkeeping. Medical records required by this standard shall be maintained in accordance with paragraph (h)(1) of this section. 1 citations