California Code of Regulations, Title 8, Section 1512. Emergency Medical Services.

Subchapter 4. Construction Safety Orders

Article 3. General

§1512. Emergency Medical Services.

(a) Provision of Services. Where more than one employer is involved in a single construction project on a given

construction site, each employer is responsible to ensure the availability of emergency medical services for its

employees. The employers on the project may agree to ensure employee access to emergency medical services

for the combined work force present at the job site. Such an emergency medical service program shall be

adequate to service the combined work force present, but only one emergency medical program need be

established at such site.

(b) Appropriately Trained Person. Each employer shall ensure the availability of a suitable number of

appropriately trained persons to render first aid. Where more than one employer is involved in a single

construction project on a given construction site, the employers may form a pool of appropriately trained

persons. However, such pool shall be large enough to service the combined work forces of such employers.

Exception: Engineering contractors or service providers on a job site not engaged in construction activity (e.g.,

operation of tools, equipment or machinery directly associated with construction) that are in compliance with

the requirements of Section 3400(b) of the General Industry Safety Orders.

(c) First-Aid Kit.

(1) Every employer working on or furnishing personnel on a construction project, on line crews and on other

short duration or transient jobs shall provide at least one first-aid kit in a weatherproof container. The contents

of the first-aid kit shall be inspected regularly to ensure that the expended items are promptly replaced. The

contents of the first-aid kit shall be arranged to be quickly found and remain sanitary. First-aid dressings shall

be sterile in individually sealed packages for each item. The minimum first-aid supplies shall be determined by

an employer-authorized, licensed physician or in accordance with the following Table:

(2) Other supplies and equipment, when provided, shall be in accordance with the documented

recommendations of an employer-authorized, licensed physician upon consideration of the extent and type of

emergency care to be given based upon the anticipated incidence and nature of injuries and illnesses and

availability of transportation to medical care.

(3) Drugs, antiseptics, eye irrigation solutions, inhalants, medicines, or proprietary preparations shall not be

included in first-aid kits unless specifically approved, in writing, by an employer-authorized, licensed

physician.

(d) Informing Employees of Emergency Procedures. Each employer shall inform all of his employees of the

procedure to follow in case of injury or illness.

(e) Provision for Obtaining Emergency Medical Services. Proper equipment for the prompt transportation of

the injured or ill person to a physician or hospital where emergency care is provided, or an effective

communication system for contacting hospitals or other emergency medical facilities, physicians, ambulance

and fire services, shall be provided. The telephone numbers of the following emergency services in the area

shall be posted near the job telephone, telephone switchboard, or otherwise made available to the employees

http://www.dir.ca.gov/title8/1512.html (2 of 4)3/28/2006 12:30:58 PM

California Code of Regulations, Title 8, Section 1512. Emergency Medical Services.

where no job site telephone exists:

(1) A physician and at least one alternate if available.

(2) Hospitals.

(3) Ambulance services.

(4) Fire-protection services.

(f) Emergency Washing Facilities. Where the eyes or body of any person may be exposed to injurious or

corrosive materials, suitable facilities for drenching the body or flushing the eyes with clean water shall be

conspicuously and readily accessible.

(g) Emergency Call Systems. A two-way voice emergency communication system shall be installed, for

buildings and structures five or more floors or 48 feet or more above or below ground level, to notify persons

designated in the emergency medical services plan. The location and condition of the employee shall be able to

be communicated over the system. The use of the construction passenger elevators for medical emergencies

shall take precedence over all other use.

Exception: Where jobsite conditions prevent or impair the communication of the required information over the

system, an alternative system acceptable to the Division shall be used.

(h) Basket Litter. At least one basket or equally appropriate litter equipped with straps and two blankets, or

other similar warm covering, shall be provided for each building or structure five or more floors or 48 feet or

more either above or below ground level.

(i) Written Plan. The employer shall have a written plan to provide emergency medical services. The plan shall

specify the means of implementing all applicable requirements in this section. When employers form a

combined emergency medical services program with appropriately trained persons, one written plan will be

considered acceptable to comply with the intent of this subsection.

NOTE: The provisions of Section 1512 are not intended to exclude immediate treatment of minor injuries

which do not require the services of a physician.

§1504. Definitions.

Emergency Medical Services.

(A) Appropriately Trained Person. A physician or registered nurse currently licensed in California or a person possessing a current certificate (training within the past three years or as specifically stated on the certificate) from the American National Red Cross or equivalent training that can be likewise verified. Acceptable Red Cross certificates are those from the Standard First-Aid Multimedia, Standard First Aid and Personal Safety, or Advanced First Aid and Emergency Care courses.

Note: Equivalent training includes, but is not limited to, training which is equivalent to that provided by the American National Red Cross, or training required for certification as mobile intensive care paramedics as provided under chapter 2.5, article 3, sections 1480 through 1484.4 of the California Health and Safety Code; and, courses that are given by nationally recognized voluntary health organizations, official agencies, such as Mine Safety and Health Administration, or accredited teaching institutions.

(B) Emergency Medical Services. The communications, transportation and medical and related services, such as first aid, rendered in response to the individual need for immediate medical care in order to reduce or prevent suffering and disability and reduce the incidence of death.

(C) First Aid. The recognition of, and prompt care for injury or sudden illness prior to the availability of medical care by licensed health-care personnel.

What are the rules concerning Bloodborne Pathogens?

INDUSTRY WIDE LABOR-MANAGEMENT SAFETY COMMITTEE

SAFETY BULLETIN #24

CALIFORNIA OSHA SAFETY REQUIREMENTS FOR HANDLING OF BLOOD AND OTHER POTENTIALLY INFECTIOUS MATERIALS

The California Department of Industrial Relations (“Cal OSHA”) Bloodborne Pathogen Standard is a series of regulations to protect workers from contracting disease through direct contact with contaminated blood and other potentially infectious materials1 (“OPIM”). This Safety Bulletin highlights certain provisions or requirements from the regulations. (See Title 8, California Code of Regulations Section 5193 for the complete text of the regulations.) See applicable Federal and other state and local regulations for other requirements when outside California. The Bloodborne Pathogens standard requires employers to protect those employees reasonably at risk (employer designated medical care providers and other employees who are assigned responsibility for responding to incidents involving blood or OPIM) from exposure to bloodborne pathogens2. Your employer is required to have a written exposure control plan which is required to be accessible to employees. (Title 8, CCR § 5193 (c)(1))

1 "Other Potentially Infectious Materials" include the following human body fluids: Semen, vaginal secretions, cerebrospinal fluid, synovial fluid, pleural fluid, pericardial fluid, peritoneal fluid, amniotic fluid, saliva in dental procedures, and any other body fluid that is visibly contaminated with blood such as saliva or vomitus, and all body fluids in situations where it is difficult or impossible to differentiate between body fluids such as emergency response. (Title 8, CCR § 5193(b))

2 "Bloodborne Pathogens" means pathogenic microorganisms that are present in human blood and can cause disease in humans. These pathogens include, but are not limited to, Hepatitis B virus (HBV), Hepatitis C virus (HCV) and Human Immunodeficiency Virus (HIV). (Title 8, CCR § 5193(b))

Universal Precautions is 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 Hepatitis B virus (HBV), Hepatitis C (HCV) Human Immunodeficiency Virus (HIV), and other bloodborne pathogens.” (Title 8, California

Code of Regulations § 5193.) “Universal Precautions shall be observed to prevent contact with blood or OPIM. Under circumstances in which differentiation between body fluid types is difficult or impossible, all body fluids shall be considered potentially infectious materials.” (Title 8, CCR § 5193 (d)(1).)

The following methods of compliance shall be observed under the Cal OSHA regulations:

1. Treat all blood and body fluids as if they are known to be infectious with HBV, HCV or HIV (Title 8, CCR § 5193(b)).

2. Use appropriate personal protective equipment (PPE) as required including gloves, face masks, eye shields, protective gowns, disposable resuscitation devices, etc. (Title 8, CCR § 5193(J)(4)(a).)

Safety Bulletin #24 Bloodborne Pathogen Revised: March 23, 2000 Page 2 of 3 SAFETY BULLETINS ARE RECOMMENDED GUIDELINES ONLY; CONSULT ALL APPLICABLE RULES AND REGULATIONS SAFETY BULLETINS MAY BE VIEWED OR DOWNLOADED FROM THE WEBSITE WWW.CSATF.ORG C:\Documents and Settings\Dhoward\Local Settings\Temporary Internet Files\OLK45\SftyBull #24 BLOODBORNE.doc

3 "Occupational Exposure" means reasonably anticipated skin, eye, mucous membrane, or parenteral contact with blood or other potentially infectious materials that may result from the performance of an employee's duties (Title 8, CCR § 5193(b)).

The employer shall make available the Hepatitis B vaccine and vaccination series to all employees who have occupational exposure, and post-exposure evaluation and follow-up for bloodborne pathogens exposure to all employees who have had an exposure incident. When an employer is also acting as the evaluating health care professional, the employer shall advise an employee following an exposure incident that the employee may refuse to consent to post-exposure evaluation and follow-up from the employer-healthcare professional. When consent is refused, the employer shall make immediately available to exposed employees a confidential medical evaluation and follow-up from a healthcare professional other than the exposed employee's employer.

EXCEPTION: Designated first aid providers who have occupational exposure are not required to be offered pre-exposure Hepatitis B vaccine if the following conditions exist:

1. The primary job assignment of such designated first aid providers is not the rendering of first aid.

a. Any first aid rendered by such persons is rendered only as a collateral duty responding solely to injuries resulting from workplace incidents, generally at the location where the incident occurred.

b. This exception does not apply to designated first aid providers who render assistance on a regular basis, for example, at a first aid station, clinic, dispensary, or other location where injured employees routinely go for such assistance, and emergency or public safety personnel who are expected to render first aid in the course of their work.

2. The employer's Exposure Control Plan, subsection (c)(1), shall specifically address the provision of Hepatitis B vaccine to all unvaccinated first aid providers who have rendered assistance in any situation involving the presence of blood OPIM (regardless of whether an actual exposure incident, as defined by subsection (b), occurred) and the provision of appropriate post-exposure evaluation, prophylaxis and follow-ups for those employees who experience an exposure incident as defined in subs (Title 8, CCR § 5193(f)(1)).

4 "Exposure Incident" means a specific eye, mouth, or mucous membrane, non-intact skin, or parenteral contact with blood or other potentially infectious material that results from the performance of an employee’s duties. (Title 8, CCR § 5193(B))

3. Efficient hand washing is the single most effective practice to prevent the spread of infection. Wash your hands immediately or as soon as feasible, after removal of gloves or other personal protective equipment (PPE). When provision of hand washing facilities is not feasible, the employer shall provide either an appropriate antiseptic hand cleanser in conjunction with clean cloth/paper towels or antiseptic towelettes. When antiseptic hand cleansers or towelettes are used, hands shall be washed with soap and running water as soon as feasible. (Title 8, CCR § 5193(I)(2))

4. Treat all needles and other sharp implements as if they are known to be contaminated with infectious material. (Title 8, CCR § 5193(b))

5. Be sure that ALL biohazard waste including contaminated PPE and sharps are disposed of properly and safely (dispose of sharps in puncture-proof containers). Refer to your employer's written exposure control plan for details. (Title 8, CCR § 5193 (g))

6. If you have an “Occupational Exposure”3 or if you have an “Exposure Incident”4 and are accidentally exposed to blood or other potentially infectious materials, a

Safety Bulletin #24 Bloodborne Pathogen Revised: March 23, 2000 Page 3 of 3 SAFETY BULLETINS ARE RECOMMENDED GUIDELINES ONLY; CONSULT ALL APPLICABLE RULES AND REGULATIONS SAFETY BULLETINS MAY BE VIEWED OR DOWNLOADED FROM THE WEBSITE WWW.CSATF.ORG C:\Documents and Settings\Dhoward\Local Settings\Temporary Internet Files\OLK45\SftyBull #24 BLOODBORNE.doc

series of Hepatitis B vaccinations and post-exposure evaluation and follow-up will be offered to you at that time, free of charge. The cost of these vaccinations is the responsibility of your employer. If you have an exposure, report the incident immediately to your supervisor and to first-aid personnel. (Title 8, CCR § 5193 (f))

The key to protection and prevention is compliance with regulations and universal precautions. Your health and safety may depend on it!