While paragraph (h)(1)(iii) requires that medical records are to be kept confidential, paragraph (h)(1)(iii)(B) stipulates that disclosure is permitted when required by this standard or other Federal, State, or local law.
Recordkeeping | Occupational Exposure to Bloodborne Pathogens
Records are required to be kept for each employee covered by this standard for training, as well as for medical records.
1. Medical records required by paragraph (h)(1) will be of particular importance to the healthcare professional in determining vaccination status and recommendation for treatment in the event of an exposure incident. Although the employer is required to establish and maintain medical records, he/she may contract for the services of a healthcare professional located offsite and that person or company may retain the records.
The requirements of §1910.1020 apply. In particular, §1910.1020(d)(1)(i)(C) provides that the medical records of employees who have worked for less than one (1) year need not be retained beyond the term of employment if they are provided to the employee upon termination of employment.
Inspection guidelines: All medical records required to be kept by this standard are also required to be made available to OSHA. The Compliance Officer must protect the confidentiality of these records. If they are copied for the case file, the provisions of §1913.10 must be followed.
The Compliance Officer should review the employer’s recordkeeping program to ensure that the required information is collected, and provision has been made to ensure the confidentiality of the medical records in accordance with §1910.1020. While §1910.1020(a) makes allowances for its provisions being carried out on behalf of the employer, §1910.1020(b)(3) states that “each employer must ensure that the preservation and access requirements are complied with regardless of the manner in which the records are made or maintained.” If the employer has contracted with a responsible third party to maintain the required records, the employer should only be cited for deficiencies of which she/he knew or could have known with the exercise of reasonable diligence.
2. Paragraph (h)(2) requires accurate recordkeeping of training sessions, including titles of the employees who attend. The records are necessary to assist the employer and OSHA in determining whether the training program adequately addresses the risks involved in each job. Additionally, this information is helpful in tracking the relationship between exposure incidents (e.g., needles-ticks) and various jobs and the corresponding level of training.
Training records may be stored onsite where the actual documents will be easily accessible for review. In order to ensure that the employee training is complete, all the components of the program required by paragraph (g)(2)(vii) must be covered.
Training records are not considered to be confidential. Training records may be stored onsite where the actual documents are readily accessible. They must be retained for three years from the training date.
3. Paragraph (h)(5) requires employers to establish and maintain a sharps injury log for the recording of percutaneous injuries from contaminated sharps. This log is separate from the log of injuries and illnesses kept under Part 1904. Employers who are already partially exempt from Part 1904 recordkeeping requirements (See 29 CFR 1904.1 and 1904.2) are not required to keep a sharps injury log, but are encouraged to do so. Federal agencies will be required to keep a sharps injury log by a revision to Part 1960 that is currently under review.
The log must include the type and brand of device involved in the incident, the department or work area where the exposure incident occurred and an explanation of how the incident occurred so that the intended evaluation of risk and device effectiveness can be accomplished. More information may be included; however the confidentiality of the injured employee must be maintained throughout the process. If the nature of the incident is such that determining the type and brand of the device would increase the potential for additional exposure (e.g., housekeeper stuck through trash bag), the type/brand may be recorded as “Unknown.”
The purpose of the log is to aid in the evaluation of devices being used in the workplace and to quickly identify problem areas in the facility. Thus, it should be reviewed regularly and during the review and update of the Exposure Control Plan.
If the data is made available to other parties (e.g., supervisors, safety committees, employees, employee representatives), any information that directly identifies an employee or any information that could reasonably be used to identify the employee must be withheld. Logs must be saved for at least five years following the end of the calendar year that they cover.
Inspection guidelines: The format of the sharps injury log is not specified. The employer is permitted to determine the format in which the log is maintained (e.g. paper or electronic) and may include information in addition to that required by the standard, so long as the privacy of the injured worker is protected. Many employers already compile reports of percutaneous injuries to comply with paragraph (f)(3). Existing mechanisms for collecting these reports could be considered sufficient to meet the requirements for maintaining a log provided that the information meets the minimum requirements specified by the standard and the confidentiality of the injured employee is protected.
Citation guidelines: Employers partially exempt from recordkeeping requirements under §1904 are exempt from the requirement of maintaining a sharps injury log, but are encouraged to do so. All employers, however, must still comply with the post-exposure documentation requirements of paragraphs (f)(3) and the annual review documentation requirements of (c)(1)(iv), even when a physical log is not required.
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