Run: Dental Bloodborne Pathogens Exposure Control Plan

This policy establishes the written **Exposure Control Plan** for preventing and reducing occupational exposure to bloodborne pathogens in dental operations. The policy is designed to comply with **OSHA 29 CFR 1910.1030** and related requirements for exposure determination, engineering and work practice controls, personal protective equipment (PPE), training, post-exposure evaluation, and recordkeeping. The policy holder is responsible for maintaining this plan in writing, making it accessible to affected employees, and reviewing it at least annually and whenever new tasks, procedures, or equipment create a change in exposure risk.

This policy applies to all employees, temporary workers, interns, and contractors who may have occupational exposure to blood or other potentially infectious materials (OPIM) in the course of dental care, sterilization, instrument handling, housekeeping, waste handling, laboratory work, or emergency response. **California employees:** follow any additional Cal/OSHA requirements that apply to bloodborne pathogen exposure control, training, and injury reporting. **Applicable roles:** dentists, hygienists, assistants, sterilization staff, front office staff with exposure risk, practice managers, and any other role assigned exposure-related duties.

- **Bloodborne pathogens:** Pathogenic microorganisms present in human blood that can cause disease. - **Occupational exposure:** Reasonably anticipated skin, eye, mucous membrane, or parenteral contact with blood or OPIM that may result from performing job duties. - **Other potentially infectious materials (OPIM):** Materials defined by OSHA 29 CFR 1910.1030. - **Exposure Control Plan:** The written plan identifying tasks, controls, training, and procedures used to eliminate or minimize exposure. - **Engineering controls:** Devices or equipment that isolate or remove the bloodborne pathogen hazard, including safer needle devices and sharps containers. - **Work practice controls:** Methods that reduce exposure risk through how tasks are performed. - **Sharps injury:** A puncture or cut from a contaminated sharp object, including needles, scalpel blades, and other sharp instruments. - **Interactive process:** The good-faith process used to evaluate work restrictions or accommodations when an employee has a medical limitation after exposure or injury.

The organization will maintain a written, site-specific exposure control plan that identifies all tasks and procedures with occupational exposure and describes the controls used to eliminate or minimize that exposure. The policy holder will ensure the following: 1. Exposure determinations are documented for job classifications and task-based assignments. 2. Engineering controls, including safer medical devices and sharps containers, are selected, implemented, and evaluated. 3. Employees use appropriate PPE and follow required work practice controls. 4. Exposure incidents are reported promptly and evaluated without retaliation. 5. The plan is reviewed and updated at least annually and whenever new tasks, procedures, or devices are introduced. 6. Training is provided at the required intervals and documented. 7. Records required by OSHA are maintained securely and retained for the required period.

### 1) Exposure determination - Maintain a list of job classifications with occupational exposure. - Identify tasks and procedures that create exposure risk, including injections, instrument cleaning, suctioning, sterilization, waste handling, and cleanup of blood spills. - Update the exposure determination whenever duties change. ### 2) Controls and safe device evaluation - Use engineering controls to reduce exposure, including needle safety devices, puncture-resistant sharps containers, and splash protection where needed. - Evaluate safer medical devices and needle devices at least annually and document the evaluation process. - Involve non-managerial employees responsible for direct patient care in the review and selection of safer devices. - Replace or remove from service any damaged or overfilled sharps container immediately. ### 3) Work practice controls - Prohibit bending, recapping, or removing contaminated needles unless no alternative is feasible and a one-handed technique or mechanical device is used. - Minimize splashing, spraying, and aerosolization during clinical and cleanup tasks. - Prohibit eating, drinking, applying cosmetics, or handling contact lenses in exposure areas. ### 4) PPE and housekeeping - Provide gloves, masks, eye protection, face shields, gowns, and other PPE appropriate to the task. - Replace PPE when contaminated, torn, or no longer protective. - Decontaminate work surfaces and reusable equipment according to approved disinfecting procedures. - Dispose of regulated waste in labeled or color-coded containers as required. ### 5) Exposure incident response - Immediately wash needlestick or cut injuries with soap and water. - Flush mucous membrane exposures with water or saline. - Report the incident to the supervisor or practice manager as soon as possible. - Arrange prompt medical evaluation, post-exposure follow-up, and documentation consistent with OSHA requirements. ### 6) Training and communication - Provide initial and annual bloodborne pathogens training to affected employees. - Train employees on exposure risks, PPE, safer devices, incident reporting, and emergency procedures. - Make the written exposure control plan accessible to employees during work hours. ### 7) Annual review and update - Review the plan at least annually. - Document the review date, changes made, and the rationale for changes. - Update the plan whenever new tasks, procedures, or devices affect exposure risk.

- **Policy holder / Practice Owner:** approves the plan, ensures resources are available, and confirms annual review. - **Practice Manager:** coordinates implementation, training records, incident reporting, and document retention. - **Clinical Supervisor / Lead Dentist:** ensures clinical staff follow work practice controls and use safer devices. - **Employees with occupational exposure:** follow the plan, use PPE, report incidents immediately, and participate in training. - **Designated safety lead:** tracks safer device evaluations, sharps injury log entries, and corrective actions. - **HR / Compliance:** supports recordkeeping, training documentation, and post-incident follow-up where employment actions or accommodations are needed through the interactive process.

Failure to follow this policy may result in retraining, documented warning, removal from exposure-prone duties, a performance improvement plan (PIP), or other corrective action up to and including termination, consistent with applicable law and any collective bargaining agreement. No employee will be retaliated against for reporting an exposure incident, requesting PPE, raising safety concerns, or participating in a good-faith investigation. If an employee has a medical limitation after an exposure incident, the organization will engage in the interactive process to determine whether a reasonable accommodation is available, provided the employee can perform the essential function of the role with or without accommodation.

- **California employees:** follow applicable Cal/OSHA bloodborne pathogen requirements, injury reporting rules, and any state-specific training or recordkeeping obligations. - **New York employees:** follow any applicable state or local workplace safety and injury reporting rules in addition to OSHA requirements. - **Other jurisdictions:** if local law provides greater protection than this policy, the more protective rule controls. - Exceptions to work practice controls or PPE requirements may be approved only by the policy holder or designated safety lead when a documented alternative provides equal or greater protection and remains compliant with OSHA 29 CFR 1910.1030.

This policy must be reviewed **annually** and whenever there is a change in tasks, procedures, equipment, or regulatory requirements that affects occupational exposure. The review should confirm: - current exposure determinations, - current safer needle device and sharps evaluations, - training completion status, - post-exposure response readiness, - sharps injury log maintenance, and - any corrective actions from incidents or audits. Version history and approval records should be retained with the policy file.