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U.S. DEPARTMENT OF TRANSPORTATION

FEDERAL AVIATION ADMINISTRATION

National Policy

ORDER

3900.71

 

 

Effective Date:

9/1/16

SUBJ:

Flight Standards Service Bloodborne Pathogens Program

The Flight Standards Service (AFS) Bloodborne Pathogens (BBP) Program is established to prevent occupational exposure of AFS employees to pathogens in blood and other potentially infectious materials (OPIM). Pathogens are microorganisms that may cause infectious diseases in humans. The AFS BBP Program requirements are in accordance with Occupational Safety and Health Administration (OSHA) Standard, Title 29 of the Code of Federal Regulations (29 CFR) part 1910, § 1910.1030, Bloodborne Pathogens; and Federal Aviation Administration (FAA) Order 3900.19, FAA Occupational Safety and Health Program. BBP may be present in situations where AFS employees encounter blood, saliva, or other potentially infectious human body materials in the course of their duties. BBP infections can be prevented through the successful application of an effective BBP Program.

This order specifies the actions necessary to protect the health and safety of all AFS employees, and provides the requirements for development, implementation, and maintenance of an effective BBP Program.

Compliance with this order enforces OSHA’s General Industry Standards and applicable industry consensus standards.

ORIGINAL SIGNED by

/s/ Michael J. Zenkovich

Deputy Director, Flight Standards Service

Table of Contents

Paragraph                                                                                                                          Page

Chapter 1.  General Information..................................................................................................1-1

1.   Purpose of This Order......................................................................................................1-1

2.   Audience..........................................................................................................................1-1

3.   Where You Can Find This Order.....................................................................................1-1

4.   Policy...............................................................................................................................1-1

5.   Scope and Application.....................................................................................................1-1

6.   Directive Feedback Information......................................................................................1-2

Chapter 2.  Roles and Responsibilities.........................................................................................2-1

1.   The Director, Flight Standards Service (AFS-1)..............................................................2-1

2.   AFS Division Managers...................................................................................................2-1

3.   Managers and Front Line Managers (FLM).....................................................................2-1

4.   AFS-Designated Bloodborne Pathogens Program Manager (BBPPM).......................... 2-1

5.   Field Office Bloodborne Pathogens Program Administrators (OBBPPA) (Appointed by Managers).................................................................................................2-2

6.   FAA Occupational Medical Surveillance (Occ Med) Program Lead or Physician or Other Licensed Health Care Professional (PLHCP)................................................... 2-2

7.   Occupational Exposure (Category 1) Employees............................................................2-3

8.   Good Samaritan/Volunteer Lay Responder-Related Exposure (Category 2)
Employees........................................................................................................................2-3

Chapter 3.  Bloodborne Pathogens Program Requirements.........................................................3-1

1.   Background......................................................................................................................3-1

2.   AFS ECP..........................................................................................................................3-1

3.   Exposure Determination...................................................................................................3-1

4.   Universal Precautions.......................................................................................................3-1

5.   Engineering and Work Practice Controls.........................................................................3-1

6.   Sample Transport.............................................................................................................3-3

7.   PPE...................................................................................................................................3-3

8.   Housekeeping...................................................................................................................3-4

9.   HBV Vaccinations, Post-Exposure Evaluations, and Followup..................................... 3-4

10.   Hazard Communication.................................................................................................3-5

11.   Training.........................................................................................................................3-6

12.   Recordkeeping...............................................................................................................3-7

13.   Program Evaluation.......................................................................................................3-7

Appendix A. Flight Standards Service Exposure Control Plan...................................................A-1

Appendix B. FAA Form 3900-21, AFS Hepatitis B Virus (HBV) Vaccination
Consent/Decline Form............................................................................................B-1

Appendix C. Definitions..............................................................................................................C-1

Appendix D. Job Aids for Engineering and Work Practice Controls..........................................D-1

Appendix E. Acronyms................................................................................................................E-1

Chapter 1.  General Information

1.    Purpose of This Order. The Flight Standards Service (AFS) Bloodborne Pathogens (BBP) Program is established and maintained to prevent occupational exposure to pathogens in blood and other potentially infectious materials (OPIM) by AFS employees. This program specifies the actions necessary to protect the health and safety of all AFS employees, and provides the requirements for development, implementation, and maintenance of an effective BBP Program.

a.    BBP Program Elements. The elements of the BBP Program are designed to meet or exceed the requirements of Occupational Safety and Health Administration (OSHA) Standard, Title 29 of the Code of Federal Regulations (29 CFR) part 1910, §and Federal Aviation Administration (FAA) Order 3900.19, FAA Occupational Safety and Health (OSH) Program.

b.    Bloodborne Pathogens Program Manager (BBPPM). The program is administered by the AFS‑designated BBPPM, utilizing the AFS Exposure Control Plan (ECP) (Appendix A, Flight Standards Service Exposure Control Plan). The BBPPM oversees employee medical vaccination, post-exposure evaluation, training, and recordkeeping support via the FAA Occupational Medical Surveillance (Occ Med) Program.

c.    BBP Program Responsibilities. AFS field office managers, including Flight Standards District Offices (FSDO), Certificate Management Offices (CMO), International Field Offices (IFO), and Aircraft Evaluation Groups (AEG) are responsible for BBP Program execution at the local level.

d.    BBP Program Implementation. The AFS OSH Office (Administrative Resources Branch (AFS-110)) will work with senior management in the implementation of this BBP Program to include the appropriation of funding for pre-exposure prophylaxis hepatitis B virus (HBV) vaccinations, post-exposure evaluations and followups (including post-exposure prophylaxis), hand-sanitizing wipes, and personal protective equipment (PPE) for use by affected employees.

2.    Audience. This order applies to all AFS employees.

3.    Where You Can Find This Order. You can find this order on the MyFAA employee Web site at https://employees.faa.gov/tools_resources/orders_notices. Inspectors can access this order through the Flight Standards Information Management System (FSIMS) at http://fsims.avs.faa.gov. Air carriers (operators) can find this order on the FAA’s Web site at http://fsims.faa.gov. This order is available to the public at http://www.faa.gov/regulations_policies/orders_notices.

4.    Policy. It is AFS policy that employees comply with the AFS BBP Program to prevent exposure to infectious diseases that could be contracted during the performance of work. This guidance represents the minimum requirements for the BBP Program. Site-specific requirements may be more stringent based upon local risk assessments.

5.    Scope and Application. This program applies to FAA AFS personnel performing work tasks that may expose them to blood, human body fluids, or OPIM. Exposure potential is categorized as Occupational Exposure (Category 1) or Good Samaritan/Volunteer Lay Responder Related Exposure (Category 2).

a.    Occupational Exposure (Category 1). This category applies to employees who are reasonably anticipated to have occupational exposure because of their job responsibilities (such as aircraft accident investigators and employees who inspect air ambulance aircraft).

b.    Good Samaritan/Volunteer Lay Responder-Related Exposure (Category 2). This category applies to employees who conduct Good Samaritan acts during a specific volunteer emergency medical incident (such as providing emergency first aid to a coworker).

6.    Directive Feedback Information. Direct questions or comments to the Organizational Resources and Program Management Division (AFS-100) at 9-NATL-AVS-AFS-OSH@FAA.gov. For your convenience, FAA Form 1320-19, Directive Feedback Information, is the last page of this order. Note any deficiencies found, clarifications needed, or suggested improvements regarding the contents of this order on FAA Form 1320-19.

Chapter 2.  Roles and Responsibilities

1.    The Director, Flight Standards Service (AFS-1). AFS-1 shall:

a.    Ensure that resources (funding and personnel) are available to effectively implement the Bloodborne Pathogens (BBP) Program throughout the organization.

b.    Oversee the overall implementation of the BBP Program in the AFS organization.

c.    Designate the AFS Bloodborne Pathogens Program Manager (BBPPM).

2.    AFS Division Managers. AFS Division Managers shall provide oversight of the BBP Program within their division.

3.    Managers and Front Line Managers (FLM). This is a management program, and managers and FLMs shall:

a.    Manage and implement BBP Program requirements within his or her jurisdiction.

b.    Identify individuals whose job functions may expose them to human blood or OPIM and identify their exposure determination category per the AFS ECP (See Appendix A, Flight Standards Service Exposure Control Plan).

c.    Designate an Office Bloodborne Pathogens Program Administrator (OBBPPA) for each field office within his or her jurisdiction.

d.    Furnish and maintain adequate disinfecting supplies and BBP-related personal protective equipment (PPE) in accordance with the AFS ECP.

e.    Ensure that employees receive BBP training in accordance with the training requirements in Chapter 3, Bloodborne Pathogens Program Requirements.

f.    Report potential or actual workplace BBP exposure incidents in the FAA Safety Management Information System (SMIS).

g.    Designate an office BBP trainer to attend the train-the-trainer sessions and provide training to the other office employees.

h.    Notify employees of potential BBP hazards in work areas through signs, notices, and other written communication, where applicable.

i.    Enforce acquisition and use of BBP PPE where required and counsel employees when appropriate.

4.    AFS-Designated Bloodborne Pathogens Program Manager (BBPPM). The AFS Designated BBPPM shall:

a.    Serve as the BBP subject matter expert (SME) for AFS and perform overall AFS BBP Program management.

b.    Provide oversight and technical guidance to AFS managers and supervisors to ensure compliance with the AFS BBP Program, FAA orders, and applicable OSHA standards.

c.    Assist field office managers with implementation of the AFS ECP.

d.    Assist managers and supervisors with the identification of employees at risk of exposure, determination of hazardous work areas and tasks that may result in exposures as well as PPE requirements.

e.    Oversee overall management of the BBP-related PPE, including standardization of PPE and any other related management/logistical need.

f.    Assist offices in any post-exposure investigations and provide oversight for followup activities.

g.    Evaluate new operations and activities that may introduce new or additional BBP exposures.

h.    Develop AFS-specific BBP training for AFS Category 1 employees and their managers who perform work at or supervise those that work at aircraft accident scenes, inspect air ambulance facilities/aircraft, or other workplaces where there is more than a Good Samaritan/Volunteer Lay Responder-Related Exposure (Category 2).

i.    Coordinate with the Occupational Medical Surveillance (Occ Med) Program Lead where needed for program compliance and effectiveness.

j.    Maintain a sharps injury log for AFS, where needed.

5.    Field Office Bloodborne Pathogens Program Administrators (OBBPPA) (Appointed by Managers). Field OBBPPAs shall:

a.    Be informed of blood and OPIM hazards associated with work areas and tasks within his or her jurisdiction.

b.    Assist manager/supervisor with ensuring office compliance with the AFS ECP and verify BBP PPE is maintained and accessible.

c.    Review post-exposure incident reports in the SMIS for employees in their office.

d.    Review reports of BBP Program evaluations.

6.    FAA Occupational Medical Surveillance (Occ Med) Program Lead or Physician or Other Licensed Health Care Professional (PLHCP). The Occ Med Program Lead or PLHCP shall maintain all post-exposure records as directed by the AFS BBPPM and the FAA Occ Med Program.

7.    Occupational Exposure (Category 1) Employees. Category 1 employees shall:

a.    Comply with this AFS BBP Program, AFS ECP, applicable OSHA standards, FAA orders, and BBP training.

b.    Participate in the HBV vaccination program and complete and sign the FAA Form 3900-21, AFS Hepatitis B Virus (HBV) Vaccination Consent/Decline Form.

c.    Understand links between BBP, blood, and OPIM exposure hazards and their duties, including procedures, work areas, tasks, and equipment.

d.    Use appropriate protective equipment whenever encountering or expecting to encounter blood or other bodily fluids in accordance with BBP training.

e.    Report potential BBP hazards to his or her supervisor.

f.    Report any BBP exposure to the manager/supervisor. Follow the post-exposure procedures in the ECP in Appendix A and provide the necessary information to the manager/supervisor to aid in the completion of the mishap report in SMIS, using FAA Form 3900-6, FAA Mishap Report. Also, notify the AFS BBPPM.

g.    Wear approved PPE where BBP and OPIM hazards exist or are expected to be encountered, and properly use hand-sanitizing supplies as presented in training.

h.    Work with the supervisor and physician, if needed, if employee has a personal health problem or if the use of PPE (e.g., latex allergy, etc.) could be aggravated by exposure to blood or OPIM hazards.

Note:  An employee does not have to disclose a specific condition to the supervisor.

8.    Good Samaritan/Volunteer Lay Responder-Related Exposure (Category 2) Employees. Category 2 employees shall:

a.    Comply with this BBP Program, AFS ECP, applicable OSHA standards, FAA Policy, and BBP training.

b.    Report potential BBP and OPIM hazards or any BBP exposure to his or her supervisor for inclusion in a mishap report in SMIS, using FAA Form 3900-6, FAA Mishap Report, if applicable.

c.    Use universal precautions whenever encountering blood or other bodily fluids in accordance with BBP awareness training.

Chapter 3.  Bloodborne Pathogens Program Requirements

1.    Background. Bloodborne pathogens (BBP) are pathogenic microorganisms present in human blood, body fluids, and OPIM that can cause disease in humans. These pathogens include, but are not limited to, the hepatitis B virus (HBV), the hepatitis C virus (HCV), and the human immunodeficiency virus (HIV). This BBP Program specifies the actions necessary to protect the health and safety of all AFS employees, and provides the requirements for development, implementation, and maintenance of an effective BBP Program.

2.    AFS ECP. The AFS ECP is provided in Appendix A and it covers all AFS employees. The Office Bloodborne Pathogens Program Administrators (OBBPPA) shall review the AFS ECP at least annually and evaluate the office’s program for effectiveness and compliance. The evaluation must be documented and include recommendations for increased effectiveness. Once the OBBPPA has completed the ECP office evaluation, it shall be reviewed and approved by the office manager.

3.    Exposure Determination. Exposure determinations are documented in this BBP Program and in the AFS ECP. Job tasks where AFS employees may be exposed to BBP are categorized into two exposure profiles:

a.    Occupational Exposure (Category 1). Category 1 employees are employees with reasonably anticipated occupational exposure because of their routine job responsibilities (such as aircraft accident investigators, employees who inspect air ambulance aircraft, and employees who prepare contaminated components for shipment).

b.    Good Samaritan/Volunteer Lay Responder-Related Exposure (Category 2). Category 2 employees are employees who conduct Good Samaritan acts during a specific volunteer emergency medical incident.

Note:  As part of the ECP, local offices shall determine the exposure category for each employee in the office and maintain a list of the employees in each category.

4.    Universal Precautions. Universal precautions is an approach for infection control where all human blood and body fluids are treated as if known to be infectious for HBV, HCV, HIV, and other BBP. These precautions shall be observed to prevent contact with blood or OPIM. Under circumstances in which differentiation between body fluid types is difficult or impossible (such as at aircraft crash investigation sites), all body fluids shall be considered potentially infectious materials. Universal precautions include engineering, work practice controls, and PPE.

5.    Engineering and Work Practice Controls. Use of engineering and work practice controls will eliminate or minimize employee exposure. When occupational exposure remains after establishing these controls, use PPE. Job aids for engineering and work practice controls are available in Appendix D, Job Aids for Engineering and Work Practice Controls.

a.    Engineering Controls.

(1)    Engineering controls consist of devices which reduce or eliminate exposure. For example, a permanent barrier between the employee and the exposure hazard or a biological sample shipping container engineered to prevent leakage and release of contents are considered engineering controls.
(2)    Engineering controls must be examined, maintained, or replaced on a regular schedule to ensure their effectiveness. This is usually the responsibility of the host facility under inspection by AFS employees.
(3)    If an AFS employee observes an engineering control that has not been properly inspected, maintained, or replaced at the host facility, the employee should include that information in a report to his or her supervisor to facilitate communication to future inspectors about the potential hazard.

b.    Work Practice Controls.

(1)    Work practices which may reduce or eliminate exposures include posting biohazard labels and placards in areas where BBP and OPIM may be present, daily and postflight disinfection of air ambulance cabins, frequent handwashing when working in such areas, and avoiding smoking, drinking, and eating in those areas.
(2)    Handwashing facilities, or hand-sanitizing supplies, must be made available to employees. This is the responsibility of the host facility in accordance with 29 CFR part 1910, § 1910.1030(d)(2)(iii) and (d)(2)(iv). However, AFS employees may conduct duties in domestic or foreign workplaces where handwashing facilities are not required or are not maintained. These issues must be reported to his or her supervisor and/or manager.
(3)    AFS employees must carry hand-sanitizing supplies to the field with them when conducting aircraft crash investigations. Hand-sanitizing supplies include alcohol gels, paper towels, clean cloths, and towelettes impregnated with antiseptic solutions and are provided in the Aviation Safety (AVS) Standardized Safety Go-Kits.
(4)    If an AFS employee uses hand-sanitizing supplies in lieu of handwashing, the employee should wash his or her hands as soon as possible with soap and clean water. Handwashing should also occur as soon as possible after removing gloves or other PPE as well as after contact with blood or OPIM. Mucous membranes should be flushed with clean water after contact.
(5)    AFS employees shall not eat, drink, smoke, apply cosmetics or lip balm, or handle contact lenses in work areas where there is a reasonable likelihood of occupational exposure to BBP or OPIM.
(6)    All procedures involving blood or OPIM shall be performed in such a manner as to minimize splashing, spraying, spattering, and generation of droplets of these substances. For example, AFS employees should execute tasks in a manner that prevents spreading blood, body tissue, or OPIM when retrieving samples, removing equipment, or gathering information at an aircraft crash site.
(7)    When conducting inspections at air ambulance operations or repair stations, AFS employees should be particularly careful of the aircraft cabin. While air carriers who perform air ambulance operations are responsible to ensure infection control training and aircraft decontamination procedures are in compliance with Federal regulations, BBP and OPIM can be invisible or inaccessible to responsible medical personnel. Components under the medical floor can be contaminated with blood and OPIM and can persist in these areas for long periods without environmental exposure. Additionally, items such as night vision goggles (NVG), oxygen bottles, or stretchers which may be subject to inspection by AFS employees, could be touched by a gloved medical crewmember during the transport of a patient with an infectious disease and inadvertently never get decontaminated.

6.    Sample Transport. Components/parts collected at aircraft crash investigation sites, which may be contaminated with blood or OPIM, shall be placed in a container which prevents leakage during collection, handling, processing, storage, transport, or shipping.

a.    Container Requirements.

(1)    The container for storage, transport, or shipping shall be labeled or color-coded according to specifications described in this chapter and closed prior to being stored, transported, or shipped.
(2)    If outside contamination of the primary container occurs, the primary container shall be placed within a second container which prevents leakage during handling, processing, storage, transport, or shipping. The second container must be labeled or color-coded.
(3)    If the component/part could puncture the primary container, the primary container shall be placed within a secondary container, which is puncture-resistant in addition to the above characteristics.

b.    Contamination of Equipment. Equipment, which may become contaminated with blood or OPIM, shall be examined prior to inspecting or shipping and decontaminated as necessary, if feasible. The AFS Occupational Safety and Health (OSH) Bloodborne Pathogens Program Manager (BBPPM) can provide decontamination guidance and supplies.

c.    Informing Affected Employees. Local offices shall ensure that this information is conveyed to all affected employees prior to handling, servicing, or shipping so that appropriate precautions will be taken.

d.    Equipment Label. A readily observable label in accordance with this BBP Program shall be attached to the equipment stating which portions remain contaminated.

e.    Decontamination Chemicals. Glutaraldehyde is used for cold sterilization at some air ambulance/repair station sites. Glutaraldehyde is toxic and is a strong irritant to the mucous membranes (eyes, nose, throat, and lungs). Decontamination wipes impregnated with chlorine and quaternary ammonium solutions are available from major household cleaning product manufacturers.

7.    PPE. When there is risk of occupational exposure, AFS managers and supervisors shall, at no cost to AFS employees, provide the necessary PPE. The AFS ECP (Appendix A) provides additional PPE requirements.

a.    PPE Requirements. Provide appropriate PPE, such as disposable gloves, coveralls, eye protection, boot covers, and N95 filtering facepiece respirators, which does not permit blood or OPIM to pass through to or reach the employee’s clothing, skin, eyes, mouth, or other mucous membranes under normal conditions of use and for the duration of time which the PPE will be used.

b.    Managers, Supervisors, and OBBPPAs Must Ensure:

(1)    That AFS employees use appropriate PPE.
(2)    PPE is readily accessible to AFS employees and in the appropriate sizes.

Note:  Applicable AFS employees shall maintain their PPE in accordance their BBP training.

8.    Housekeeping. AFS managers, supervisors, OBBPPAs, and employees shall:

a.    Keep worksites in a clean and sanitary condition whenever possible.

b.    Clean and decontaminate equipment and surfaces after contact with blood or OPIM.

c.    Bring disposable trash bags with them to ensure that they do not leave potentially contaminated materials behind (unless biohazard disposal containers are available).

d.    Place biohazard waste in containers that are closable, contain all contents and prevent fluid leaks; are labeled or color-coded to indicate biohazard waste; are closed prior to transporting from the site; and placed in a secondary container if leakage or spillage may occur during transport.

e.    Handle contaminated laundry as little as possible with a minimum of agitation and dispose of as biohazard waste.

f.    Inspect and decontaminate reusable containers which have a reasonable likelihood for becoming contaminated with blood or OPIM as soon as feasible upon visible contamination. This may include plastic tubs used to transport aircraft crash investigation tools and supplies.

g.    Not store potentially contaminated samples with sharp edges in a manner that requires employees to reach into the containers.

9.    HBV Vaccinations, Post-Exposure Evaluations, and Followup.

a.    Pre-Exposure Prophylaxis. Employees in Category 1 will be offered the HBV vaccination series as a pre-exposure prophylaxis.

b.    Post-Exposure Prophylaxis. Employees in Categories 1 and 2 will be offered the vaccinations recommended by the physician after a BBP exposure incident has occurred during the post-exposure followup within 72 hours of the exposure incident. The U.S. Department of Labor’s (DOL) Office of Workers’ Compensation Programs (OWCP) does not cover post-exposure prophylaxis. See the BBP ECP in Appendix A for post-exposure procedures.

c.    Declining/Accepting Vaccination. FAA Form 3900-21, AFS Hepatitis B Virus (HBV) Vaccination Consent/Decline Form must be completed by any employee who is offered the vaccine, either declining or accepting vaccination.

d.    Pre-Exposure/Post-Exposure Procedures. See the AFS ECP (Appendix A) and FAA Order 3900.19 for detailed procedures to follow for pre-exposure and post-exposure activities.

e.    Post-Exposure Evaluation and Followup. Following a report of exposure, the employee and his or her manager must follow the procedures in the AFS ECP in Appendix A.

f.    Documentation. The AFS BBPPM will assist the manager in ensuring that physicians providing post‑exposure evaluation and followup services receive the appropriate documentation.

g.    Written Opinion After Post-Exposure Evaluation and Followup.

(1)    The health care professional should ensure the employee is provided a copy of the evaluating health care professional’s written opinion within 15 business days of the completion of the evaluation.
(2)    The health care professional’s written opinion for post-exposure evaluation and followup 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 OPIM which require further evaluation or treatment.
(3)    All other findings or diagnoses shall remain confidential and shall not be included in the health care professional’s written report.

10.    Hazard Communication.

a.    Biohazard Labels. Labels that include the biohazard symbol shall be affixed to regulated waste containers, sample containers, and OPIM. Labels shall be fluorescent orange or orange-red with lettering in a contrasting color. Labels can be purchased from most safety supply houses or label companies.

Figure 1. Fluorescent orange biohazard sign with black symbol and lettering.

b.    Contaminated Equipment. Labels pertaining to contaminated equipment shall state which portion of the equipment is contaminated.

c.    Waste Bags. Red plastic biohazard waste bags or red puncture-resistant containers may be substituted for labels.

Figure 2. Red Plastic Biohazard Waste Bags

d.    Air Ambulance Sites. AFS personnel conducting inspections at air ambulance sites should note whether biohazard signs have been posted in work areas where BBP and OPIM are located.

e.    Biohazard Signs. Signs shall be fluorescent orange or orange-red with contrasting letters and numbers, and include the name of the infectious agent, special requirements for entering the area; and the name, telephone number of the person responsible for the area.

11.    Training. AFS shall provide BBP training to occupationally exposed (Category 1) AFS employees and managers. Supervisors shall ensure employee participation in the training.

a.    Training Frequency. Training must be provided at the time of initial assignment to tasks where occupational exposure may take place, and at least annually thereafter. Training must also be provided when changes such as modification of tasks or procedures, or institution of new tasks or procedures, affect the employee’s occupational exposure. The additional training may be limited to addressing the new exposures created.

b.    Train-the-Trainer Classes. The AFS BBPPM will develop and facilitate train-the-trainer classes on the AFS BBP Program to ensure that AFS BBP instructors shall be knowledgeable in the subject matter. The train‑the-trainer classes will be available within 12 months of the date of this order. The field offices will be notified of the classes via their regional OSH point of contact (POC).

c.    Training Content.

(1)  Initial AFS BBP training for Category 1 employees shall include the following:
(a)    OSHA BBP Standard and an explanation of its contents;
(b)    The epidemiology and symptoms of bloodborne diseases and the modes of transmission of BBP;
(c)    Tasks with potential exposure, universal precautions, and how to implement them;
(d)    Explanation of the AFS ECP and how employees can obtain copies of it;
(e)    Explanation of BBP-engineering controls, work practices, and PPE;
(f)    Use, selection, decontamination, and disposal of PPE;
(g)    Demonstrate proper donning and doffing of disposable coveralls and gloves;
(h)    Review of the efficacy, safety, method of administration, and benefits of the HBV vaccine; and a statement that it is available, free of charge to AFS employees covered under the BBP Program;
(i)    Procedures to follow if an exposure incident occurs, including the method of reporting the incident, post-exposure evaluation, and followup services;
(j)    Signs, labels, and color-coding; and
(k)    An interactive question and answer period with the instructor(s).
(2)  Category 1 employees must take an annual refresher BBP training course.
(3)  Category 2 employees must take an initial BBP awareness training course.
(4)  Category 2 employees who participate in the FAA Public Access Defibrillator (PAD) Program must receive refresher BBP training annually.

d.    Refresher Training. Annual training is required on the AFS ECP, proper don or doff of PPE, and any site-specific procedures for all Category 1 employees.

12.    Recordkeeping.

a.    Medical Records. All occupational medical records must be retained in accordance with the FAA Occ Med Program. AFS employee occupational medical records shall be maintained for the duration of employment plus 30 years. The AFS OSH Program Office will evaluate the recordkeeping at least every 3 years.

b.    Training Records. AFS employee BBP training records shall be recorded in the FAA electronic Learning Management System (eLMS). Records must contain the employee’s name, job title, training dates, and training content and/or summary.

c.    Sharps Injury Log. In addition to the 29 CFR Part 1904, Recording and Reporting Occupational Injuries and Illnesses, managers and supervisors must record all reports of percutaneous injuries from contaminated sharps in SMIS. The AFS BBPPM must also record these injuries in the AFS Sharps Injury Log in accordance with § 1910.1030.

13.    Program Evaluation. The effectiveness of the AFS BBP Program shall be evaluated at the individual office level and at the AFS OSH Program Office level annually. The individual office level evaluations should involve the local Occupational Safety Health and Environmental Compliance Committee (OSHECCOM).

a.    Documentation. The findings of the program evaluation shall be documented and shall include recommendations for program corrections, modifications, and additions.

b.    Submission. Local and headquarters offices shall send program evaluations annually in response to BBPPM annual requests.

Appendix A.  Flight Standards Service Exposure Control Plan

1.0    Introduction.

The major intent of the Occupational and Health Administration’s (OSHA) Bloodborne Pathogens (BBP) regulation (Title 29 of the Code of Federal Regulations (29 CFR) part 1910, § 1910.1030) is to prevent the transmission of bloodborne diseases within potentially exposed workplace occupations. Implementing the OSHA BBP requirements is expected to reduce and prevent employee exposure to the hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV), and other bloodborne diseases.

The BBP regulation requires that employers follow universal precautions, which means that all blood or other potentially infectious materials (OPIM) must be treated as being infectious for HBV, HCV, HIV, and other BBP.

Each employer must determine the application of universal precautions by performing an employee exposure evaluation. If employee exposure is recognized, as defined by the BBP regulation, then the regulation mandates a number of requirements. One of the major requirements is the development of an exposure control plan (ECP), which mandates engineering controls, work practices, personal protective equipment (PPE), HBV vaccinations, and training. The BBP regulation also mandates practices and procedures for housekeeping, medical evaluations, hazard communication, and recordkeeping.

2.0    Policy Statement.

The Federal Aviation Administration (FAA) Flight Standards Service (AFS) is committed to providing a safe and healthful work environment for employees. In pursuit of this endeavor, the following AFS ECP is provided to eliminate or minimize occupational exposure to BBP in accordance with the § 1910.1030, Public Law (PL) 106-430, Needlestick Safety and Prevention Act (2000), and FAA Order 3900.19, FAA Occupational Safety and Health Program. This ECP is a key document to assist FAA AFS in implementing and ensuring compliance with the standard; thereby protecting FAA employees.AA Occupational Safety and Health Program. This ECP is a key document to assist FAA AFS in implementing and ensuring compliance with the standard; thereby protecting FAA employees.

Contractors are not covered under this ECP; they are covered by their individual employers’ ECP and/or clauses within FAA contracts. For example, FAA and the General Services Administration (GSA) contract out housekeeping functions and tasks; the employees under those contracts fall under those contracts and their own employer exposure determinations, policies, and procedures.

3.0    Employee Exposure Determination.

AFS employee job responsibilities fall into two BBP Program employee categories regarding occupational and voluntary incident contact with or exposure to blood or OPIM.

3.1   Occupational Exposure (Category 1) Employees. Employees with reasonably anticipated occupational exposure because of their routine job responsibilities. These tasks involve exposure to human blood, body fluids, human tissue, and OPIM. These employees are offered the option of receiving the HBV vaccination at no charge.

3.2   Good Samaritan/Volunteer Lay Responder-Related Exposure (Category 2) Employees. Employees who conduct Good Samaritan acts during a specific volunteer emergency medical incident. Good Samaritan acts are acts which result in exposure to blood or OPIM from assisting a fellow employee (e.g., assisting a coworker with a nosebleed, giving cardiopulmonary resuscitation (CPR)/Automated External Defibrillator (AED), or first aid). These employees are not included in/covered by OSHA’s BBP regulation. However, AFS is including these employees in the AFS ECP so employees may understand about BBP exposure, universal precautions, and employee and agency actions in response to exposure. These employees will be offered a post-exposure medical evaluation and followup as appropriate and post-exposure prophylaxis as recommended by a physician through a reimbursement process detailed in section 4.7 below.

3.3   Table 1, FAA Employee Exposure Determinations. Summaries the BBP Program employee categories, employee job responsibilities, job classifications/employee groups, and whether a HBV vaccination would be offered. The exposure determinations are without regard to the use of PPE.

Table 1.  FAA Employee Exposure Determinations

BBP Program Employee Category

Job Responsibility

(includes but is not limited to)

Offered HBV Vaccination

Category 1 Employees

Employees designated to respond to and/or conduct aircraft accident investigations.

Yes

Employees designated to inspect air ambulance aircraft (fixed-wing and/or rotorcraft).

Yes

Category 2 Employees

Conducts Good Samaritan acts during a specific volunteer emergency medical incident. May include, but not limited to,

·    Providing first aid involving blood and OPIM

·    Providing CPR and/or using AED

·    Cleaning up a BBP spill (but not officially assigned to do such)

Exposed employees will be offered post-exposure evaluation and followup as appropriate.

4.0    Methods of Implementation and Control.

4.1   Universal Precautions.

4.1.1    Universal precautions is an infection control method requiring employees to assume that all human blood and specified human body fluids are infectious for HBV, HCV, HIV, and other BBP and must be treated accordingly.
4.1.2    Employees will utilize universal precautions to prevent contact with blood or OPIM. Under circumstances in which differentiation between body fluid types is difficult or impossible, such as at aircraft crash investigation sites, all body fluids shall be considered potentially infectious materials.
4.1.3    Universal precautions supplement rather than replace work practice controls and engineering controls, such as handwashing, using PPE, and HBV vaccination pre-exposure prophylaxis.

4.2   AFS Work Practice Controls and ECP General Requirements.

4.2.1    Handwashing facilities (i.e., sinks, potable water, soap dispenser, and paper towels) at staffed FAA facilities are available to employees in every restroom.
4.2.2    Antiseptic wipes are to be provided for those Category 1 employees whose designated work activities are conducted at non-fixed sites or at multiple employee worksites, which lack handwashing facilities (i.e., emergency scenes).
4.2.3    Employees who require the use of needles for personal medical reasons, such as insulin injections, are responsible for the storage, transportation, and proper disposal of their own materials.
4.2.4    Spills of blood or OPIM on work surfaces and work areas will be cleaned promptly with an appropriate Environmental Protection Agency (EPA)-approved disinfectant.
4.2.5    If a sharp (i.e., syringe or needle) is found in an AFS office, secure the immediate location of the sharp and contact the manager. The manager will work with building management for proper handling and disposal of the sharp and cleanup of the location.
4.2.6    For BBP-related engineering and work practice controls, and universal precautions requirements, see Chapter 3, Bloodborne Pathogens Program Requirements, of this order.
4.2.7    AFS Employees will receive an explanation of the AFS ECP during their initial BBP training session. It will also be reviewed in their annual refresher training.
4.2.8    The AFS Bloodborne Pathogens Program Manager (BBPPM) will review and update the ECP annually to reflect new information as needed.

4.3   Housekeeping.

4.3.1    If included in the lease language, the building owner or the owner’s building management are responsible for ensuring that areas of BBP spills are cleaned up, and any found miscellaneous sharp hazards are properly handled and disposed, and cleanup of the location occurs.
4.3.2    A BBP spill kit should be available at AFS office locations but employees are not expected to clean up bodily fluids. The BBP spill kit usually contains antiseptic wipe(s), antiseptic gel, paper towels, a pair of nitrile gloves, absorbent powder, a scoop and small scraper, and a bag with a tie.

4.4   PPE.

4.4.1    PPE must be used if occupational exposure remains after instituting engineering and work practice controls, or if the controls are not feasible.
4.4.2    Front line supervisors/managers are responsible for ensuring appropriate PPE is accessible and used by their employees, and that the PPE is provided at no cost to the employees, in accordance with this order.
4.4.3    Employees must be trained in the use of the appropriate PPE for employees’ specific job classifications and tasks/procedures they will perform. This training will be conducted in accordance with this order.
4.4.4    Additional training will be provided, whenever necessary, such as if an employee takes a new position or if new duties are added to their current position.
4.4.5    Table 2, BBP-related PPE and Associated Tasks, lists the minimum PPE and equipment required for the AFS BBP Employee Categories.

Table 2.  BBP-Related PPE and Associated Tasks

BBP Employee Category

BBP PPE

BBP-Related Equipment

Category 1 — Aircraft Accident Investigators

·    Various sizes of latex/vinyl/nitrile disposable gloves

·    Safety glasses or goggles

·    N95 filtering facepiece respirator(s)

·    Chemical-resistant disposable garments (necessary for limiting chemicals (known and unknown) and infectious agents from passing through or reaching the employee’s work clothes, street clothes, and undergarments under normal conditions of use and for the duration of time which the PPE will be used)

·    Chemical-resistant disposal boot covers or boots

·    Antiseptic wipes/‌Hand sanitizer

·    Plastic trash bags

·    EPA-approved disinfectants/sterilants

Category 1 — Aviation Safety Inspectors (ASI) (who inspect air ambulance aircraft (fixed‑wing and/or rotorcraft))

·    Various sizes of latex/vinyl/nitrile gloves

·   Safety glasses

·    N95 filtering facepiece respirator(s)

·    BBP-resistant disposable garments (necessary for limiting infectious agents from passing through or reaching the employee’s work clothes, street clothes, and undergarments under normal conditions of use and for the duration of time which the PPE will be used)

·    Chemical resistant booties or boots

·    Antiseptic wipes//‌Hand sanitizer

·   Plastic trash bags

·    EPA-approved disinfectants/sterilants

Category 2 — Any FAA Employee (who conducts “Good Samaritan” acts during a specific volunteer emergency medical incident)

·    First aid kit that contains latex/vinyl/nitrile gloves

·    FAA PAD Program AED Kit contains latex/vinyl/nitrile gloves

·   Breathing barrier

·   FAA first aid kits

·   Antiseptic wipes

4.5   Pre-Exposure and Post-Exposure Prophylaxis.

4.5.1    Employees in Category 1 will be offered the HBV vaccination series as a pre-exposure prophylaxis.
4.5.2    Employees in Category 1 and 2 will be offered the post-exposure medical evaluation and followup as appropriate and post-exposure prophylaxis as recommended by a physician within 72 hours of the exposure incident.
4.5.3    FAA employees who are offered HBV vaccination, either pre-exposure prophylactically or after a documented exposure, may choose not to receive the vaccination. The Centers for Disease Control and Prevention (CDC) recommends that employees receive the HBV vaccination for illness prevention. However, if an employee chooses to decline the HBV vaccination, then the employee must sign an OSHA-required statement to this effect on the FAA Form 3900-21, AFS Hepatitis B Virus (HBV) Vaccination Consent/Decline Form.
4.5.4    An employee can decline the HBV vaccination when offered and at a later time, while still covered under the AFS BBP Program, decide they want the HBV vaccination and it will be provided. The employee must sign a statement updating their information that they consent to the vaccination on the FAA Form 3900-21, AFS Hepatitis B Virus (HBV) Vaccination Consent/Decline Form.
4.5.5    The FAA will coordinate all aspects of the HBV vaccination at no charge to employees and the HBV vaccination will be given during work hours by a physician or other licensed health care professional (PLHCP).
4.5.6    When employees are offered the HBV vaccination, the employees will review the CDC’s Hepatitis B General Information Fact Sheet and the CDC’s Hepatitis B Vaccine Information Statement (VIS), and receive a copy of FAA Form 3900-21, AFS Hepatitis B Virus (HBV) Vaccination Consent/Decline Form.
4.5.7    Copies of these documents are posted on the AFS Occupational Safety and Health (OSH) Web site (my.faa.gov/go/AFSOSH). Employees will also be given a chance to ask a medical physician questions about the vaccination. The vaccination can be received at a local clinic, at the office of a personal doctor, or other licensed health care provider. The vaccination is administered in accordance with United States Public Health Service (USPHS)-recommended protocol, current at the time of the evaluations and procedures. Per the current USPHS/CDC‑recommended protocol:
1.   A routine booster is not recommended.
2.   Serologic testing (i.e., antibody testing) for immunity is not necessary after routine vaccination of adults.

a.   Testing after vaccination is recommended only for employees who are immunocompromised (e.g., persons undergoing chemotherapy, stem cell transplant, or persons who are HIV-infected).

b.   Please Note that the immuno-status of an employee is medically confidential information. If any employee has a specific question about serologic testing for themselves, the employee should contact their health care provider.

4.5.8    Prior to any vaccination or if employees have medical questions about their HBV vaccination status or the USPHS/CDC-recommended protocol, employees will be given a chance to ask a health care professional questions.
4.5.9    The HBV vaccination must be made available after receiving the required training and within 10 business days of initial assignment to all employees who have occupational exposure. These requirements do not apply if:
1.   The employee has previously received the complete HBV vaccination series;
2.   Antibody testing has revealed that the employee is immune; or
3.   The vaccine is contraindicated for medical reasons.
4.5.10   The FAA will not pay for booster shots or titer tests based on the CDC recommendations, but will pay for HBV vaccinations. If the CDC changes its recommendations, the FAA will revisit the procedures.
4.5.11   Employees have access to the OSHA BBP regulation on the OSHA Web page found at www.osha.gov, using regulation number § 1910.1030.

4.6   Post-Exposure Medical Evaluation and Followup.

4.6.1   Following a report of an exposure incident, the employee must see a PLHCP at a local urgent care clinic, personal physician, or other clinic where they will receive a confidential medical evaluation and initial treatment available to the employee within 24 hours. The evaluation and followup must be in accordance with § 1910.1030.
4.6.2    The BBPPM and the employee’s supervisor/manager, will also ensure that the PLHCP evaluating an employee after an exposure incident receives the following:
1.   A description of the employee’s job duties relevant to the exposure incident;
2.   Route(s) of exposure;
3.   Circumstances of exposure;
4.   If possible, results of the source individual’s blood test; and
5.   Relevant employee medical records, including vaccination status.
4.6.3    The FAA employee must have the PLHCP provide to the FAA Occ Med Program a written opinion on the medical evaluation within 15 business days of completion of the evaluation, providing only the information that OSHA requires to be provided to the employer.
4.6.4    For HBV vaccinations, the PLHCP’s written opinion will be limited to whether the employee requires or has received the HBV vaccination.
4.6.5    The PLHCP’s written opinion for post-exposure evaluation and followup will be limited to whether or not the employee has been informed of the results of the medical evaluation and any medical conditions which may require further evaluation and treatment.
4.6.6    All other diagnoses will remain confidential between the PLHCP and the employee, and not be included in the PLHCP’s written opinion to FAA.
4.6.7   The AFS HBV Vaccination Consent/Decline Form and any vaccination records will be maintained in Employee Medical Folders (EMF) in the FAA’s Employee Medical File System (EMFS), which is governed by the Privacy Act System of Record entitled OPM/GOVT‑10, Employee Medical File System Records.

4.7   Procedures When a BBP Exposure Incident Occurs.

4.7.1    In the event of a known or probable BBP exposure incident, an employee shall inform their supervisor/manager. The supervisor/manager shall then immediately contact the regional OSH point of contact (POC) and the BBPPM.
4.7.2    The supervisor/manager will ensure the employee receives the post-exposure evaluation which may or may not include vaccinations as recommended by the physician no later than 24 hours after the supervisor/manager contacts the BBPPM.
4.7.3    The employee’s supervisor/manager must report the BBP exposure incident in the FAA Safety Management Information System (SMIS) in the same manner as other occupational injuries or illnesses.
4.7.4    Medical expenses incurred as a result of Good Samaritan acts are not likely to be covered by the U.S. Department of Labor’s (DOL) Office of Workers’ Compensation Programs (OWCP) process since it does not cover preventive care, including testing or vaccinations. OWCP will likely cover any costs relating to an illness contracted as a result of volunteer response to a workplace emergency.
4.7.5    To initiate the OWCP process, the affected employee’s FLM should provide Forms CA-1 and CA-16 to take to the initial appointment. If a case is denied by the DOL, the medical practitioner’s office should submit the bill for payment to the employee’s private health insurance. Any copays or other costs not covered by private insurance paid out by the employee will be considered for reimbursement through the Form SF1164, Claim for Reimbursement for Expenditures on Official Business, process. This will be addressed on a case-by-case basis and, if approved, an accounting code will be provided for the Accounting Classification field on the form.
4.7.6   The employee’s supervisor, with assistance from the BBPPM will investigate, document, and evaluate the circumstance of the exposure incident including, but not limited to:
1.   Date, time, and location of the incident;
2.   Procedure being performed when the incident occurred;
3.   Engineering controls and work practices followed;
4.   A description of the device being used (including type and brand);
5.   Protective equipment or clothing that was used at the time of the exposure incident (gloves, eye shields, etc.); and
6.   Employee’s training.
4.7.7    Upon completion of the BBP Exposure Investigation, the BBPPM will provide potential root causes and recommendations to prevent a recurrence of the BBP exposure to employees. These findings will be distributed for review during annual BBP refresher training.

4.8   Training. See Chapter 3 of this order for training requirements.

4.9   Recordkeeping.

4.9.1   Occupational Medical Records. Occupational medical records are maintained in EMFs in the FAA EMFS, which is maintained by the FAA Occ Med Program. The FAA Occ Med Program maintains these records in accordance with the FAA EMFS Implementing Instructions, part 1910, § 1910.1020, Access to Employee Exposure and Medical Records, and Title 5 of the Code of Federal Regulations (5 CFR) part 293, Subpart E, Employee Medical File System Records.
4.9.1.1    The original employee medical records such as HBV forms are sent via FedEx in secured envelopes labeled as “For Official Use Only” to the local Occ Med records custodian.
4.9.1.2    Offices also have the option to send paperwork electronically via email as a backup. To protect personally identifiable information (PII), the sender should encrypt the scanned PDF forms using SecureZIP with a password and email the ZIP file to the Occ Med documents custodian. Immediately follow this email with another message containing the password to open that ZIP file. Please note that the password-protected ZIP file and password should never be sent in the same message.
4.9.2   Training Records. See Chapter 3 of this order for requirements on training records.

Appendix B. FAA Form 3900-21, AFS Hepatitis B Virus (HBV) Vaccination Consent/Decline Form

U.S. Department of Transportation (DOT) Logo

US Department of Transportation Federal Aviation Administration

FAA Form 3900-21, AFS Hepatitis B Virus (HBV) Vaccination Consent/Decline Form

PRIVACY ACT STATEMENT. Collection of the information requested on this form, including the Social Security number (SSN), is necessary for processing actions related to the administration of the AFS Bloodborne Pathogens (BBP) Program and the FAA Occupational Medical Surveillance (Occ Med) Program that is required by Occupational Safety and Health Administration (OSHA) Regulation, Title 29 of the Code of Federal Regulations (29 CFR) part 1910, § 1910.1030. Collection of your SSN is authorized by Executive Order 9397 and will be used by the FAA Occ Med Program as an employee identification number. Furnishing the requested information, including your SSN, is voluntary but failure to provide all of the requested information may result in delay in processing actions related to the FAA AFS BBP Program and Occ Med Programs. The collected information will become part of the following system of records: Office of Personnel Management (OPM)/GOVT-10, Employee Medical File System Records. The routine uses of this system apply to the information collected. OPM/GOVT-10, Employee Medical File System Records is available at www.gpo.gov.

Section A.  Understanding Reason(s) for Receiving the HBV Vaccination.

Please read the general Hepatitis B and Hepatitis B Virus (HBV) Vaccination information as well as the following two Centers for Disease Control and Prevention (CDC) documents, which are posted on the AFS Occupational Safety and Health (OSH) Web site (my.faa.gov/go/AFSOSH):

·     CDC’s Hepatitis B General Information Fact Sheet

·     CDC’s Hepatitis B Vaccine Information Statement

No vaccination should be considered without some understanding of the issues for why a vaccine is suggested and what implications might apply to specific individuals. If you have any questions, the FAA Occ Med Program will ensure an FAA Occ Med Program Health Care Provider is available for questions.

Section B.  Decline Receiving the HBV Vaccination.

NO, I DECLINE to receive HBV vaccine.

I understand that due to my occupational exposure to blood or other potentially infectious materials (OPIM), I may be at risk of acquiring HBV infection. I have been given the opportunity to be vaccinated with HBV vaccine at no charge to me. However, I DECLINE HBV vaccination at this time. I understand that by declining this vaccine I continue to be at risk of acquiring HBV, a serious disease. If in the future I continue to have occupational exposure to blood or OPIM and I want to be vaccinated with HBV vaccine, I can receive the vaccine series at no charge to me. I also understand that the AFS BBP Program and the FAA Occ Med Program will have access to this form. I understand that declination of HBV vaccine does not relieve me of the requirement to perform assigned job functions as directed by my supervisor (such as investigation of aircraft accidents/incidents or inspection of air ambulance aircraft as identified in the AFS BBP Program and Exposure Control Plan (ECP)).

Name (Type or Print)

 

Signature

Date

Section C.  Consent to Receiving the HBV Vaccination.

YES, I CONSENT to receive HBV vaccine.

I have read the information given to me about the Hepatitis B virus and HBV vaccine (i.e., information on p. 2 of this form, the CDC Hepatitis B General Information Fact Sheet, and the CDC Hepatitis B Vaccine Information Statement), and I have had the opportunity to ask questions which were answered to my satisfaction.

I CONSENT to participating in a vaccination program. I understand this includes three injections at prescribed intervals over a six-month period. I further understand that there is no guarantee that I will become immune to the Hepatitis B virus or that I will not experience an adverse side effect as the result of the vaccination.

Name (Type or Print)

 

Social Security Number

 

Telephone Number

 

Facility and StreetAddress

 

City

 

State

 

Zip Code

 

Signature

Date

Section D.  Health Care Provider Employee Suitability Determination for the HBV Vaccine.

Determination of Employee Suitability for the HBV Vaccine:

(Mark an “X” in the box that represents your determination.)

___ NEEDS vaccine

___ DOES NOT NEED vaccine

___ Vaccine CONTRAINDICATED

Additional Comments by the Health Care Provider

 

 

 

Health Care Provider’s Name (Print or Type)

 

 

Signature

Date

Section E.  HBV Vaccination Record

Employee’s Name:

 

Dose

Date Given

Lot Number

Administered By

(PRINT NAME & PROVIDE SIGNATURE

Next Date Due

1

 

 

 

 

2

 

 

 

 

3

 

 

 

 

** Maintain this form in the Employee’s Medical Folder

Instructions for Completing FAA Form 3900-21, AFS Hepatitis B Virus (HBV) Vaccination Consent/Decline Form

Purpose of Form. FAA Form 3900-21, AFS Hepatitis B Virus (HBV) Vaccination Consent/Decline Form is required by the AFS Bloodborne Pathogens (BBP) Program FAA Order 3900.71 and the FAA Occupational Medical Surveillance (Occ Med) Program. The form has three purposes:

1.   Document an employee’s choice to consent to or decline the receipt of the vaccination when the employee has been offered the opportunity to receive the HBV Vaccination.

2.   Provide a location for FAA Occ Med Program’s Health Care Provider or another PLHCP to document their determination as to the appropriateness of providing the HBV Vaccination to the employee that has indicated they consent to receive the HBV Vaccination.

3.   Provide a location for the FAA Occ Med Program’s Health Care Provider or another PLHCP to document the HBV Vaccination Record for the employee that has indicated they consent to receive the HBV Vaccination.

Privacy Act Statement. Civil service Occ Med records are personnel records and are owned by the Office of Personnel Management (OPM). However, each civilian Agency is required to be the custodian of Occ Med records generated on its own employees while the employee is employed by the civilian Agency. OPM stipulates the use of individual Employee Medical Folders (EMF) as the methodology to organize employee-specific Occ Med records. Further, the EMFs must be organized into an Employee Medical File System (EMFS). OPM’s Privacy Act of 1974 (the Privacy Act) system of records document entitled OPM/GOVT-10, Employee Medical File System Records covers these records, including the records in FAA’s EMFS.

This form collects some personally identifiable information (PII) including, Social Security number (SSN); this is a requirement by Occupational Safety and Health Administration (OSHA) regulation as well as to ensure occupational medical records are placed into the correct employee’s EMF. Executive Order 9397 allows for the collection of the SSN. Providing the SSN is voluntary. Forms without the SSN provided will require the FAA Occ Med Program to confirm the identity of the employee through additional processes and the program will place the employee’s SSN on the paperwork prior to filing the form into the employee’s EMF.

Black line separating section.

Section A. Understanding Reason(s) for Receiving the HBV Vaccination.

1.   The employee obtains and/or receives the consent/decline form.

2.   The following general information is provided about Hepatitis B and the HBV Vaccination.

THE DISEASE: Hepatitis B is a virus that is transmitted by blood and body fluids. People most often become infected with the Hepatitis B virus (HBV) through unprotected sexual intercourse with an infected partner or by sharing needles with an infected person. Accident investigators may come in direct contact with blood and body fluids and may be at risk for exposure to HBV. Hepatitis B may be characterized by fever, loss of appetite, nausea, abdominal pain, fatigue, and jaundice. Consequence of Hepatitis B infection might include cirrhosis, liver cancer, or death. In addition, obtaining HBV may result in the employee becoming a chronic carrier and source of infection to others.

THE VACCINE: Immunization with the Hepatitis B vaccine can prevent acute Hepatitis B infection and can also reduce the chance of death from long-term complications of HBV infection. According to OSHA Regulation, 29 CFR 1910.1030 (Bloodborne Pathogens), employees who are at risk of occupational exposure to blood must be offered the Hepatitis B vaccination series. Several safe and effective vaccines against HBV use only a portion of the virus and are produced in the laboratory from common baker’s yeast cells. It is not made from blood or blood products. The vaccine cannot transmit HBV or other BBP like the human immunodeficiency virus (HIV).

The immunization process is a series of three doses of vaccine given according to the following schedule: The 1st dose will be at an elected date, the 2 nd dose will be 1 month later, and the 3rd dose will be six months after the 1st dose.

THE VACCINE EFFECTIVENESS: Over 90% of healthy people who receive the full course of immunization will develop protective immunity. The duration of this immunity is unknown but it is estimated to be at least 5 to 7 years. People who are immune because of natural infection do not require vaccination.

SIDE EFFECTS OF THE VACCINATION: The Hepatitis B vaccine is usually well tolerated. Local soreness at the injection site is the most frequent reaction. Low-grade fever lasting 48 hours, malaise, fatigue, headaches, nausea, muscle soreness, joint pain (all limited to a few days after vaccination), and rash have been reported. Very rarely have cases of neurological reaction, including Guillain-Barré syndrome, have been reported. Individuals who are or may be pregnant should discuss the vaccination with their private physician. Individuals who have allergies to yeast or Thimerosal (commonly used in contact lens solution) should not be vaccinated.

3.    Please read two Centers for Disease Control and Prevention (CDC) documents which are posted on the AFS Occupational Safety and Health (OSH) Web site (my.faa.gov/go/AFSOSH):

·     CDC’s Hepatitis B General Information Fact Sheet

·     CDC’s Hepatitis B Vaccine Information Statement

4.    If you have any questions, the FAA Occ Med Program will ensure that an FAA Occ Med Program Health Care Provider is available to respond to your questions. You may also wish to consult with your personal physician if you have a current illness, chronic medical condition, or doubts regarding allergies or vaccines.

5.     After reading the background information and discussing the issue as needed, you choose to either:

·     Decline Receiving the HBV Vaccination (Go to Section B).

·     Consent to Receiving the HBV Vaccination (Go to Section C).

Black line separating section.

Section B.  Decline Receiving the HBV Vaccination.

If declining the HBV vaccination, sign and date the form area in Section B, you must provide the original or scanned version of the signed form to the FAA Occ Med Program for filing in the employee’s Employee Medical Folder (EMF). You should make a copy of the signed declination for your records prior to providing the original signed form to the FAA Occ Med Program. Methods for providing FAA Form 3900-21 to the FAA Occ Med Program:

1.   Complete the fillable PDF form and digitally sign or print the form and complete. As the form has PII, utilize encryption in sending the form via email to the account:

·     Right click on the file, go to SecureZip and proceed over to: Zip and email: “file name.zip”

·     Enter a password twice {8 characters both upper/lower and a number) ex. “Form3495”

·     Click OK and Close

·     An MS Outlook email opens and send to: 9-FAA-OCCMED-Rec-Submit@faa.gov.

2.   In a second email, provide the password you created and send to: 9-FAA-OCCMED-Rec-Submit@faa.gov

3.   If you do not have access to a computer with SecureZip or prefer to mail the document, send to:

FAA Occ Med Program, AJV-E31, Office 120-207

1701 Columbia Ave., College Park, GA 30337

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Section C.  Consent to Receiving the HBV Vaccination.

1.    Read FAA Form 3900-21 Hepatitis B virus information and if you consent to receive the HBV vaccine, please complete Section C on the form by filling in the employee identification blocks, sign, and date.

2.    You will receive the vaccination at a local clinic, at the office of a personal doctor, or from another licensed health care provider, where you can take the form and receive a determination if it is appropriate for you to receive the HBV vaccination. If so, then you will receive the vaccination shot(s). You will leave the form with the health care provider so that vaccination details may be made directly on FAA Form 3900-21. A copy of the final form must be provided to the Occ Med Program for inclusion in your EMF.

Note:  Prior to providing the form to the health care provider, you should make a copy of the signed consent for your records.

Black line separating section.

Section D. Health Care Provider Determination of Employee Suitability for the HBV Vaccine.

1.    You are seeing this FAA employee because the employee has indicated that he/she consents to receive the HBV vaccination. However, please evaluate the medical suitability of him/her for the HBV vaccine.

2.    Upon making a determination, please indicate that determination by marking an “X” in one of the three options listed in Section D (i.e., Needs vaccine; Does not need vaccine; Vaccine contraindicated).

3.    There is also a place for additional comments should you wish to do so, but they are not required.

4.    If you have determined either the FAA employee “does not need the vaccine” or the “vaccine is contraindicated,” please document this on the form and ensure it is sent in for inclusion in the EMF.

Black line separating section.

Section E.  HBV Vaccination Record – Filled out by the Health Care Provider

You are seeing this FAA employee because the employee has indicated that he/she consents to receiving the HBV vaccination and you have determined that the employee can receive the HBV vaccine. Please complete the vaccine record for each dose given and follow the procedures. Please ensure that this document is placed in the specific employee’s medical folder.

Appendix C.  Definitions

1.    Title 29 CFR Part 1910. Title 29 of the Code of Federal Regulations, Occupational Safety and Health Standards.

2.    Blood. Human blood, human blood components, and products made from human blood.

3.    Bloodborne Pathogens (BBP). Pathogenic microorganisms present in human blood that can cause disease in humans. These pathogens include, but are not limited to, the hepatitis B virus (HBV), the hepatitis C virus (HCV), and the human immunodeficiency virus (HIV).

4.    Contaminated. The presence of, or the reasonably anticipated presence of, blood or other potentially infectious materials (OPIM) on an item or surface.

5.    Contaminated Laundry. Laundry which has been soiled with blood or OPIM, or laundry that may contain sharps contaminated with blood or OPIM.

6.    Contaminated Sharps. Any contaminated object that can penetrate the skin including, but not limited to, needles, scalpels, broken glass, broken capillary tubes, and exposed ends of dental wires. For FAA AFS employees, this definition may include sharp-edged parts collected from aircraft crash sites and sharp edges of aircraft flooring removed from air ambulances.

7.    Decontamination. The use of physical or chemical means to remove, inactivate, or destroy BBP on a surface or item to the point where they are no longer capable of transmitting infectious particles and the surface or item is rendered safe for handling, use, or disposal.

8.    Engineering Controls. Controls (e.g., sharps disposal containers, self-sheathing needles, safer medical devices, such as sharps with engineered sharps injury protections and needleless systems) that isolate or remove the BBP hazard from the workplace.

9.    Exposure Incident. A specific eye, mouth, other mucous membrane, non-intact skin, or parenteral contact with blood or OPIM that results from the performance of an employee’s duties.

10.  Good Samaritan/Volunteer Lay Responder-Related Exposure (Category 2). This category applies to employees who conduct Good Samaritan acts during a specific volunteer emergency medical incident (such as providing emergency first aid to a coworker).

11.  Handwashing Facilities. A facility providing an adequate supply of running potable water, soap, and single-use towels or air-drying machines.

12.  Licensed Health Care Professional. A person whose legally permitted scope of practice allows him or her to independently perform the activities required by Chapter 3, paragraph 9, HBV Vaccinations, Post-Exposure Evaluations, and Followup, and paragraph 10, Hazard Communication.

13.  Hepatitis B Virus (HBV). Refer to the Centers for Disease Control and Prevention’s (CDC) HBV Web page at http://www.cdc.gov/hepatitis/HBV/index.htm.

14.  Hepatitis C Virus (HCV). Refer to the CDC’s HCV Web page at http://www.cdc.gov/hepatitis/HCV/index.htm.

15.  Human Immunodeficiency Virus (HIV). Refer to the CDC’s HIV Web page at http://www.cdc.gov/hiv/basics/whatishiv.html.

16.  Isolette. An incubator for premature infants that provides controlled temperature and humidity and an oxygen supply.

17.  Occupational Exposure (Category 1). This category applies to employees who are reasonably anticipated to have occupational exposure because of their job responsibilities (such as aircraft accident investigators and employees who inspect air ambulance aircraft).

18.  Other Potentially Infectious Materials (OPIM).

a.    The following human body fluids: semen, vaginal secretions, cerebrospinal fluid, synovial fluid, pleural fluid, pericardial fluid, peritoneal fluid, amniotic fluid, saliva in dental procedures, any body fluid that is visibly contaminated with blood, and all body fluids in situations where it is difficult or impossible to differentiate between body fluids.

b.    Any unfixed tissue or organ (other than intact skin) from a human (living or dead).

c.    HIV-containing cell or tissue cultures, organ cultures, and HBV-, HCV-, or HIV-containing culture medium or other solutions; and blood, organs, or other tissues from experimental animals infected with HBV, HCV, or HIV.

19.  Parenteral. Piercing mucous membranes or the skin barrier through such events as needlesticks, human bites, cuts, and abrasions.

20.  Personal Protective Equipment (PPE). Specialized clothing or equipment worn by an employee for protection against a hazard. General work clothes (e.g., uniforms, pants, shirts, or blouses) not intended to function as protection against a hazard is not considered to be PPE.

21.  Regulated Waste. A liquid or semi-liquid blood or OPIM; contaminated items that would release blood or OPIM in a liquid or semi-liquid state if compressed; items that are caked with dried blood or OPIM and are capable of releasing these materials during handling; contaminated sharps; and pathological and microbiological wastes containing blood or OPIM.

22.  Source Individual. Any individual, living or dead, whose blood or OPIM may be a source of occupational exposure to the employee. Examples include, but are not limited to, hospital and clinic patients; clients in institutions for the developmentally disabled; trauma victims; clients of drug and alcohol treatment facilities; residents of hospices and nursing homes; human remains; and individuals who donate or sell blood or blood components.

23.  Sterilize. The use of a physical or chemical procedure to destroy all microbial life including highly resistant bacterial endospores.

24.  Universal Precautions. An approach to infection control. According to the concept of universal precautions, all human blood and certain human body fluids are treated as if known to be infectious for HBV, HCV, HIV, and other BBP.

25.  Work Practice Controls. Controls that reduce the likelihood of exposure by altering the manner in which a task is performed.

Appendix D.  Job Aids for Engineering and Work Practice Controls

Job Task: Aircraft Accident Investigations                                                                                                     

Engineering and Work Practice Controls:

·    Participate in the Federal Aviation Administration (FAA) Occupational Medical Surveillance (Occ Med) Program Hepatitis B Vaccination Program if you are medically able to do so.

·    Receive bloodborne pathogens (BBP) training before executing tasks where you may be exposed.

·    Check with the site incident commander or Incident Command System (ICS) Safety Officer for a safety briefing before entering the crash site. Request information about any BBP or other potentially infectious materials (OPIM) that may be present.

·    Do not approach the aircraft until fires have been extinguished.

·    Do not smoke, eat, drink, chew gum, use oral forms of tobacco, apply cosmetics, or insert contact lenses in the crash site area.

·    Place aircraft parts that may be contaminated with blood or OPIM in containers that prevent spills or leaks; label the containers with proper biohazard labels; note which portions of the parts appear to be contaminated; and use infectious waste shipping containers, labels, and Shipper’s Declarations for Dangerous Goods if sending the parts to another location by air or ground transport services.

·    Decontaminate any non-disposable supplies with 1:10 bleach solution (1 part household bleach to 9 parts water) before leaving the site.

·    Double-bag all contaminated waste in biohazard waste bags.

·    Bring antiseptic/disinfecting wipes to the field and disinfect your hands before leaving the site.

·    Double-bag contaminated, non-disposable laundry in biohazard waste bags, dispose of as regular waste, and order replacements.

·    Report any potential exposures to BBP or OPIM immediately to your supervisor; keep records of what you were doing; and where, when, and how the exposure occurred.

·    Participate in post-exposure evaluation and followup activities, if necessary, and follow the orders of physicians who conduct the evaluation and recommend followup actions.

·    Report unsafe conditions to your supervisor immediately and use the Unsatisfactory Condition Report (UCR) as needed.

·    Recommend changes or improvements to engineering and work practice controls to your supervisor based on your experiences.

·    Do not perform a task if you cannot do so safely. Wait until conditions improve or you have the right training and equipment to work safely.

Job Task: Air Ambulance Operator Inspections                                                                                                    

Engineering and Work Practice Controls:

·    Participate in the FAA Occ Med Program Hepatitis B Vaccination Program if you are medically able to do so.

·    Receive BBP training before executing tasks where you may be exposed.

·    Stay clear of aircraft and medical personnel while patients are on board or being loaded or unloaded.

·    Check with the pilot in command (PIC) or medical crewmember for a safety briefing before entering the air ambulance site. Request information about any BBP or OPIM that may be present. Be considerate and do not interfere with current air ambulance operations.

·    Ask the operator if the aircraft has been disinfected since the last MEDEVAC flight before approaching the aircraft. Find out what types of disinfectants were used, and if any residual hazards remain.

·    Before entering the aircraft, put on appropriate exam gloves and do a visual scan of the cabin area. OPIMs could be invisible on cabin surfaces, but could still be infectious and transmitted if touched.

·    Be alert for signs of blood or OPIM contamination in aircraft cabins and floors. Be especially alert for pooled blood and OPIM in the seats tracks or beneath the surficial flooring of air ambulance aircraft during maintenance operations.

·    Be alert for signs of sharps such as syringes, scalpels, lancets, or intravenous (IV) connections that were not properly disposed of in sharps containers on board the aircraft. Emergency flights are stressful and not all actions may have been performed properly in the course of attempting to keep a severely ill or injured patient alive during the flight. If loose sharps are found, do not touch them. Notify the operator immediately.

·    Approach all medical equipment (i.e., stretchers, oxygen bottles, isolettes, etc.) and appliances (i.e., night vision goggles, helmets, aircraft flashlights, etc.) that are temporarily external to the aircraft as potentially contaminated. Exam gloves should be worn during inspection of these items.

·    Do not smoke, eat, drink, chew gum, use oral forms of tobacco, apply cosmetics, or insert contact lenses in the work area.

·    Decontaminate any non-disposable supplies with 1:10 bleach solution (1 part household bleach to 9 parts water) before leaving the site.

·    Use operator’s biohazard waste area for disposal of personal protective equipment (PPE), if necessary. If not available, double-bag all contaminated waste in biohazard waste bags.

·    Clean hands using antiseptic cleaners or alcohol-based hand sanitizers before leaving site to prevent cross‑contamination.

·    Double-bag contaminated, non-disposable laundry in biohazard waste bags, dispose of as regular waste, and order replacements.

·    Report any potential exposures to BBP or OPIM immediately to your supervisor; keep records of what you were doing; and where, when, and how the exposure occurred.

·    Participate in post-exposure evaluation and followup activities if necessary, and follow the orders of physicians who conduct the evaluation and recommend followup actions.

·    Report unsafe conditions to your supervisor immediately and use the UCR as needed.

·    Recommend changes or improvements to engineering and work practice controls to your supervisor based on your experiences.

·    Do not perform a task if you cannot do so safely. Wait until conditions improve or you have the right training and equipment to work safely.

Appendix E.  Acronyms

Acronym

Description

29 CFR Part 1910

Title 29 of the Code of Federal Regulations, Occupational Safety and Health Standards

AED

Automated External Defibrillator

AEG

Aircraft Evaluation Group

AFS

Flight Standards Service

AVS

Aviation Safety

BBP

Bloodborne Pathogens

BBPPM

Bloodborne Pathogens Program Manager

CDC

Centers for Disease Control and Prevention

CMO

Certificate Management Office

CPR

Cardiopulmonary Resuscitation

ECP

Exposure Control Plan

eLMS

Electronic Learning Management System

EMF

Employee Medical Folder

EMFS

Employee Medical File System

EPA

Environmental Protection Agency

FAA

Federal Aviation Administration

FLM

Front Line Manager

FSDO

Flight Standards District Office

GSA

General Services Administration

HBV

Hepatitis B Virus

HCV

Hepatitis C Virus

HIV

Human Immunodeficiency Virus

ICS

Incident Command System

IFO

International Field Office

IV

Intravenous

OBBPPA

Office Bloodborne Pathogens Program Administrator

Occ Med

Occupational Medical Surveillance

OPIM

Other Potentially Infectious Materials

OSH

Occupational Safety and Health

OSHA

Occupational Safety and Health Administration

PAD

Public Access Defibrillation

PL

Public Law

PLHCP

Physician or Other Licensed Health Care Professional

PPE

Personal Protective Equipment

SME

Subject Matter Expert

SMIS

Safety Management Information System

SSN

Social Security Number

UCR

Unsatisfactory Condition Report

USPHS

United States Public Health Service

VIS

Vaccine Information Statement

DOT logo

U.S. Department

of Transportation

Federal Aviation

Administration

FAA Form 1320-19, Directive Feedback Information

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FAA Form 1320-19 (8-89)