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G.O. 22 LONGWOOD POLICE DEPARTMENT GENERAL ORDER NUMBER: GO - 22 SUBJECT: SAFETY IN THE WORKPLACE EFFECTIVE: OCTOBER 1, 1995 REVISED: APRIL 1, 2022 GENERAL ORDER SAFETY IN THE WORKPLACE GO – 22 PAGE 1 OF 16 I. PURPOSE The purpose of this directive is to establish a basic management philosophy on safety in the work place. II. SCOPE A. The Longwood Police Department exercises a vital role in providing a variety of services to the citizens of the City of Longwood. While services vary, there exists the potential risk of accidental injury to Longwood Police Department employees and/or members of the community. B. All personnel are expected to comply with the provisions related to worker safety as referenced in this General Order and other directives of the Longwood Police Department. C. Supervisory personnel are expected to observe all internal operations and correct safety shortcomings and deficiencies that surface within their areas of responsibility. Individuals who observe safety deficiencies will bring the issue to the attention of an immediate supervisor. D. The following job classifications have been determined to be at risk for occupational exposure: 1. Sworn Officer 2. Evidence Custodian 3. Field Service Officer 4. Citizen on Patrol GENERAL ORDER SAFETY IN THE WORKPLACE GO – 22 PAGE 2 OF 16 E. The Longwood Police Department has a Hepatitis B Vaccination Program that is available to all members with occupational exposure. The program is strictly voluntary and offered to the members, free of cost. III. BLOOD BORNE PATHOGEN EXPOSURE CONTROL PLAN Pursuant to standards promulgated by the Occupational Safety and Health Administration (O.S.H.A.), and codified as 29 C.F.R. 1910.1030, the Longwood Police Department has implemented a Blood borne Pathogen Exposure Control Plan for all sworn personnel and applicable non-sworn personnel. The purpose of this plan is to reduce occupational exposure to blood borne pathogens such as Human lmmunodeficiency Virus (H.I.V.), Hepatitis B Virus (H.B.V.), and other blood borne pathogens that employees may encounter in the course of their work. A. Transmission of H.B.V. / H.I.V. 1. The Center for Disease Control (C.D.C.) recognizes the following fluids as directly linked to the transmission of H.B.V. I H.I.V.. a. Blood; b. Synovial Fluid (clear lubricating fluid from a joint); c. Cerebrospinal Fluid (fluid surrounding the brain/spine); d. Pleural Fluid (fluid surrounding the lungs); e. Amniotic Fluid (fluid protecting fetus from injury); f. Semen and Vaginal secretions; g. Pericardial Fluid (fluid surrounding the heart); h. Saliva (fluid secreted from the mouth). B. Exposure Control Plan (ECP) 1. Work practices shall include, but are not limited to, the assumption that all body fluids and tissues are infectious. Additionally, that all sharps, (see definition), items and instruments associated with body fluids and tissues are also infectious. In light of this, employees must utilize all Universal Precautions and Personal Protection Equipment (P.P.E.) that is available and practical to the situation. GENERAL ORDER SAFETY IN THE WORKPLACE GO – 22 PAGE 3 OF 16 2. In the event of a suspected exposure the incident will be documented by a “First Report of Injury” and an Infectious Exposure Report (I.E.R.). The employee must be tested and medically evaluated by a physician within 24 hours of the incident. It may be necessary to administer a booster of the H.B.V. - B vaccine following an exposure incident. Periodic testing will continue through the course of employment as prescribed by the attending physician. An Exposure Incident is considered a specific eye, mouth, or other mucous membrane, non-intact skin, or parenteral contact with blood or other potentially infectious materials that result from the performance of an employee’s duties. 3. In the event that a source individual is either incarcerated or admitted to a psychiatric facility or a medical facility, a request for “Disease Determination” must be completed. This form will instruct the facility holding the source individual to be tested for a Communicable Disease Determination, pursuant to. The Ryan White Comprehensive AIDS Resource Emergency Act. 4. The incident resulting in the exposure will be evaluated by an Incident Review Board. This board, consisting of the officer’s supervisor, the Infection Control Officer, and the Patrol Lieutenant, will interview the officer and any witnesses to determine if there are additional precautions and/or should be taken to eliminate similar incidents from occurring in the future. C. Universal Barrier Precautions Employees shall use appropriate Universal Barrier Precautions to prevent skin and mucous membrane exposure when contact with blood to other bodily fluid is anticipated. 1. Medical Grade Disposable Gloves: a. Gloves shall be worn when touching blood and body fluids, Mucous membranes, or non-blood or body fluids. Gloves should be discarded after contact with source individuals. 2. Personal Protection Kit: a. This shall be used when contact is likely to result in splashes of blood or other body fluid to the employee’s mouth, nose, and eyes. The kit should be discarded appropriately and replaced after usage. GENERAL ORDER SAFETY IN THE WORKPLACE GO – 22 PAGE 4 OF 16 3. Pocket Mask: a. The pocket mask shall be used anytime that C.P.R. or contact mouth to mouth is to be administered. The one way air valve should be discarded after contact with each subject and not reused. The mask must be decontaminated with bleach or other suitable cleansing products prior to continued usage. 4. Hand Cleaner a. Alcohol foam or other suitable cleaner shall be used immediately following any contact with blood or body fluids. As soon as possible after the contact, and after glove removal, employees should thoroughly wash hands and other skin surfaces with soap and water. 5. Sharps Container a. This shall be used to hold all sharps (see definition) that are submitted for any reason, including evidence or destruction purposes. To prevent needle stick injuries, needles shall not be recapped, purposely bent or broken by hand, removed from disposable syringes, or otherwise manipulated by hand. The entire sharps container shall be sealed and submitted for evidence by following standard procedures for submission. D. Tasks and procedures during which occupational exposure can occur include: 1. Handling crime scenes 2. Handling prisoners and victims 3. Accidents involving injuries 4. Rendering first-aid 5. Handling evidence and drug paraphernalia E. Documentation will be prepared when members have cause to believe they have had high-risk exposure during a line-of-duty activity. Examples of high-risk exposure include but are not limited to: 1. Handling of bloody or wet items, where scratches, cuts or open sores are noticed on the area of contact. GENERAL ORDER SAFETY IN THE WORKPLACE GO – 22 PAGE 5 OF 16 2. Direct contact with bodily fluids from a suspect on an area where there is an open sore or cut. 3. Direct mouth to mouth resuscitation. 4. The receiving of a cut or puncture wound as a result of searching or arresting a suspect. 5. The receiving of a human bite. 6. A supervisor will be contacted and an “Exposure Incident Form” and “First Report of Injury” report detailing the extent of exposure will be completed. 7. Paper cuts, hangnails, ant bites, etc. are considered non-intact skin. It is a misconception that absent a visible open wound, blood contact is not considered an exposure incident. Officers should consider incidents which involve potentially infectious bodily fluids as exposure incidents independent of whether cuts or sores are visible and should be treated as such. 8. Persons of high-risk groups or who are known to be infectious or say they are infectious should be treated with caution. Persons in high-risk groups may be contacted as victims, witnesses, bystanders, as well as suspects and/or offenders. All incidents involving possible contact with bodily fluids containing blood should be treated as high-risk encounters. Extreme caution should be used during the search of suspected drug users or dealers to prevent accidental skin punctures by needles. Extreme caution must also be used when reaching into areas that are not visible, such as under car seats. Subjects taken into custody with blood or bodily fluids on their person shall be taken directly to the county correctional facility (if no medical attention is needed, and/or medically cleared by rescue personnel). 9. If a member was, or reasonably believes to have been, substantially exposed to an infectious disease, the member will immediately notify a supervisor, who will in turn, notify the Infectious Control Officer. If the determination is made to continue medical evaluation, the employee will contact their supervisor who will complete the appropriate paperwork. GENERAL ORDER SAFETY IN THE WORKPLACE GO – 22 PAGE 6 OF 16 F. Exposure Treatment 1. Once an exposure has occurred or there is significant reason to believe an exposure has taken place, notification is the first step in the exposure management system. Florida Administrative Code, Chapter 10D-28.131 (1) states that “Notification of exposure to a selected infectious disease, either verbal or written, must take place within 48 hours of a confirmed diagnosis.” Once the agency’s Infectious Control Officer has been notified by a hospital of an exposure, or if an employee reports one, verification is the next step. 2. Verification is the process of determining if a reported exposure poses a real health risk to the member. If an exposure is verified, a recommendation for treatment is then made. The type and timing of treatment may be long or short term. Diseases that usually require post- exposure treatment include HIV, HBV, non-A and non-B Hepatitis, Meningitis, and Tuberculosis. When an employee reports an exposure incident they will have an immediate opportunity to receive a medical evaluation. It is the employee’s responsibility to notify the shift supervisor who shall notify the Infectious Control Officer. G. Post-Exposure Follow-Up 1. Upon report of an exposure incident, the Infectious Control Officer (ICO) will be contacted to determine the extent of the exposure and what follow up procedures are to be conducted. The City shall make available to the exposed employee a confidential medical evaluation and follow- up. 2. For each incident the following paperwork must be completed and a copy forwarded to the ICO: a. Infectious Exposure Report b. First Report of Injury Form c. Other reporting responsibilities will be completed by the ICO. Documentation of the route of exposure and circumstances surrounding the incident shall be maintained by the ICO. Information concerning the source individual for identification GENERAL ORDER SAFETY IN THE WORKPLACE GO – 22 PAGE 7 OF 16 and documentation shall also be maintained unless prohibited by law. The ICO shall coordinate with the Health Department and or attending physician as necessary. The source individual’s blood shall be tested as soon as feasible after consent is obtained in order to determine HBV and HIV infectivity. Failure to consent shall be documented. If the source individual’s consent is not required by law, their blood (if available) shall be tested and results documented. When the source individual is already known to be infected with HBV or HIV, no further testing is required. The employee will be supplied with the results of the source individual’s test results and advised of applicable laws concerning disclosure of the identity and infectious status of the source individual. Upon receiving consent, the City will have the exposed employee’s blood tested as soon as feasible at no cost to the employee. The City shall provide counseling and evaluation of the reported illness when medically indicated. Upon request by the attending physician, the ICO shall provide the health care professional with a copy of the regulations, the employee’s job description, all documentation as to the source and route of exposure, test results of source and employee when available, vaccination status of the employee and all relevant medical records of the employee. The ICO shall provide the employee a copy of the health care professional’s written opinion within fifteen (15) days of completion. If necessary, the ICO will coordinate with Advent Health Exposure Hotline per City contract. Significant exposures to the AIDS virus can be treated immediately. If the exposure was the result of possible infected bodily fluids, contacting an injury or open wound, whether or not the wound occurred during the incident or was previously sustained, Worker’s Compensation provisions will govern how the employee will be compensated. If at any time the employee requests the assistance of the Employee Assistance Program (E.A.P.) provider or other GENERAL ORDER SAFETY IN THE WORKPLACE GO – 22 PAGE 8 OF 16 departmental personnel, every effort should be made to provide this assistance. IV. BIOHAZARDOUS WASTE AND CONTAMINATION MANAGEMENT A. Employees must remove PPE as soon as possible following the exposure incident and appropriately dispose of the contaminated materials. B. Used gloves must be placed into the “red bag” located in any of the following locations: an ambulance, hospital, fire apparatus, or the Longwood Police Department as soon as possible. C. All other soft waste and PPE must be placed into the “red bag” located at the Longwood Police Department immediately following the exposure incident. If the material is evidence, it must be properly packaged and placed into a “red bag” prior to submission. D. “Red bags,” “sharps tubes”, and any other containers, designed for the disposal of bio-hazard contaminated material, which is NOT evidentiary in nature, will be sealed and disposed of in the clearly labeled bio-hazard disposal box in the large property and refrigerated storage area. The contents of the disposal box will be routinely collected by a contracted medical waste disposal service. E. If a garment is contaminated, employees must remove it immediately or as soon as feasible. This garment or contaminated laundry, must be cleaned prior to further usage or wearing. The contaminated garment must be washed immediately by the employee. An O.S.H.A. approved washing machine is available at Longwood Fire Department Station 15. The garment will be washed in the machine with hot water and detergent designated by fire department personnel for the purposes of laundering clothing contaminated with bio- hazardous substances. F. If a vehicle is contaminated the vehicle will be decontaminated as soon as possible. A supervisor will be notified and will then determine how the vehicle will be decontaminated. Incidents of minor contamination will be managed by an employee decontaminating the vehicle with an appropriate disinfectant while wearing disposable medical grade gloves. For heavy contamination the vehicle will be taken to the Seminole County Correctional Facility and decontaminated. If decontamination at the Seminole County Correctional Facility is not an option a biohazard cleaning service will be contracted. 1. If a biohazard cleaning service must be contracted, the employee will complete the following procedures as soon as possible after contamination. GENERAL ORDER SAFETY IN THE WORKPLACE GO – 22 PAGE 9 OF 16 a. Contaminated vehicles will be immediately placed out of service, secured at the Longwood Police Department and designated as a biohazard by posting a clearly visible biohazard sign. b. Protective disposable gloves, and all other necessary personal protection equipment, will be worn during this process. c. The ICO will be notified that the vehicle requires decontamination. G. If an area at the police department becomes contaminated, the area will be clearly marked with signs as a biohazard and decontaminated as soon as possible. Minor contamination will be managed by an employee disinfecting the area with an appropriate disinfectant while wearing disposable medical grade gloves. For heavy contamination the ICO will be notified and then will make arrangements to have the area decontaminated by a biohazard cleaning service approved by the chief of police or designee. Employees will use all necessary personal protection equipment (P.P.E.) during the cleaning and disinfection process. H. If equipment becomes contaminated the equipment will be sealed in a “red bag” until decontaminated. Minor contamination will be managed by an employee disinfecting the equipment with an appropriate disinfectant while wearing disposable medical grade gloves. Heavily contaminated equipment will be decontaminated using the Longwood Fire Department approved equipment decontamination process in the designated decontamination area at Longwood Fire Department Station 15. I. All issued Personal Protective Equipment (P.P.E.) shall be stored and maintained in each employee’s assigned vehicle and/or work environment readily available at all times. Whenever replacement equipment is needed, the employee shall immediately request such through their immediate chain of command. V. HEPATITIS B IMMUNIZATION PROGRAM Employees who have direct exposure to blood and other potentially infectious materials on their jobs run the risk of contracting bloodbourne infections from Hepatitis B Virus (H.B.V.), Human Immunodeficiency Virus (H.I.V.) and other pathogens. A. After receipt of infectious disease training, and within ten working days of initial assignment, all at-risk employees will be offered (free to the employee) a series of three injections that immunize against H.B.V. The second injections will be thirty days following the first injection, and the third injection will be five months following. Approximately six weeks after the final injection, an H.B.V. Surface Antibody Titer Test will be conducted to ensure an acceptable level of GENERAL ORDER SAFETY IN THE WORKPLACE GO – 22 PAGE 10 OF 16 immunization. The immunization will be conducted at a reasonable time and by the Seminole County Health Department or City contracted physician. B. The participating or declining employee will be required to sign an Immunization Acknowledgement Form. Participating employees will be made aware, by the contracted / administering physician or Seminole County Health Department of the potential side effects of the immunization process. Declining employees can elect, at any time in the future, to accept the offer of free immunization. C. Immunity to H.B.V. generally lasts approximately five years, after which, the employee can revaccinate. An H.B.V. Titer level will be drawn to determine if sufficient antibody response is present. If antibody response is not sufficient, one booster injection will be administered. VI. TRAINING PROGRAM AND ANNUAL REVIEW A. The Longwood Police Department shall implement a training program for all employees who are in high-risk exposure occupations, such as sworn members and property and evidence personnel. B. The training will be conducted by the Training Division of the Longwood Police Department or any other agency or personnel determined to be appropriate by the chief of police. C. Training for all new employees considered at risk shall be conducted within ten working days of initial assignment. Annual refresher training will be conducted for all members. D. Training records shall be maintained for a minimum of three years, and will include the names of the employee receiving the training, the dates the training was administered, the names of the course instructor(s), and the lesson plan utilized for the training. E. The training program/lesson plan shall consist of the following, at a minimum: 1. Familiarization with the agency’s infectious disease policy including the O.S.H.A. regulation. 2. Familiarization with the personal protective equipment that is available for use. 3. Familiarization with the basic epidemiology and symptoms of blood borne diseases. 4. Familiarization with the modes of transmission of blood borne diseases. GENERAL ORDER SAFETY IN THE WORKPLACE GO – 22 PAGE 11 OF 16 5. Exposure control procedures. 6. Information about hepatitis. 7. Recognizing the international biohazardous waste symbol and familiarization with the agency’s biohazardous waste disposal procedures. 8. Explanation of work methods, which will prevent or reduce exposure. 9. An explanation of what procedures to follow if an exposure occurs, to include post exposure follow-up. 10. Question and answer period. F. The Longwood Police Department will conduct an annual review of its Exposure Control Plan and Training to ensure that it is consistent with current infectious diseases, blood borne pathogens, treatments and immunizations, and handling and exposure procedures. The chief will designate a department member as the Infectious Control Officer. The I.C.O. will be responsible for conducting the annual review. The I.C.O. will also be responsible for ensuring that all personnel have received the proper training as outlined in this directive. VII. SIGNS, LABELS, AND COLOR CODING IDENTIFYING BIOHAZARDOUS WASTE ACCORDING TO OSHA 1910.1030 (G) (1) (I) A. Colored “Red” or labeled with the biohazard symbol; B. The label shall be “fluorescent orange” or “orange-red” colored, with lettering and symbols in a contrasting color; C. “Red” colored bags or containers may be substituted for labels VIII. DEFINITION OF TERMS Acute (disease) - of short duration, usually with abrupt onset, and sometimes sever (as opposed to chronic disease). GENERAL ORDER SAFETY IN THE WORKPLACE GO – 22 PAGE 12 OF 16 AIDS – the most severe manifestation of infection with the human immunodeficiency virus (HIV). Amniotic Fluid – the watery fluid that surrounds the fetus or an unborn child in the uterus. Antibody Positive – the result of a test or series of tests to detect antibodies in blood. A positive result means that antibodies are present. Antiviral Drug – a drug that can interfere with the life cycle of a virus. Appropriate Disinfectant – Agency provided disinfectant or a solution of household bleach made within 24 hours of use and diluted in water at a dilution of 1:10. ARC (AIDS-Related Complex or Condition) – a term that has been used to describe a variety of symptoms caused by HIV infection. These symptoms are usually less severe than those associated with AIDS and can include loss of appetite, weight loss, fever, night sweats, skin rashes, diarrhea, tiredness, lack of resistance to infections and swollen lymph nodes. Asymptomatic – having a disease-causing agent in the body but not showing outward signs of the disease. AZT – first FDA-approved drug used to treat AIDS. Blood – means human blood, human blood components, and products made from human blood. Bloodbourne 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 (H.B.V.) and human immunodeficiency virus (H.I.V.). Body Fluids – fluids that the body makes, for example, semen, blood, vaginal secretions, and breast milk. Carrier – a person who apparently is healthy, but who is infected with some disease- causing organism (such as HIV or HBV) that can be transmitted to another person. Center for Disease Control (CDC) – Federal health agency that is a branch of the U.S. Department of Health and Human Services. The CDC provides national health and safety guidelines and statistical data on AIDS and other diseases. Chronic (disease) – lasting a long time, or recurring often. Contaminated – means the presence or the reasonably anticipated presence of blood or other potentially infectious materials on an item or surface. GENERAL ORDER SAFETY IN THE WORKPLACE GO – 22 PAGE 13 OF 16 Contaminated Laundry – means laundry which has been soiled with blood or other potentially infectious materials or may contain sharps. Contaminated Sharps – means 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. Cytomegalovirus (CMV) – a viral infection that may occur without any symptoms or results in mild flu-like symptoms. Severe CMV infections can result in hepatitis, mononucleosis, or pneumonia. CMV is ashed in body fluids. In the presence of immune deficiency, such as AIDS, it can also affect other internal organs and vision, sometimes leading to blindness. Decontamination – means the use of physical or chemical means to remove, inactivate, or destroy bloodbourne pathogens 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. Bleach is generally a suitable household cleanser and decontaminate. Diagnosis – Identifying a disease by its signs, symptoms, course, and laboratory findings. Elisa Test – a screening blood test for the presence of antibodies to HIV. A positive result from Elisa test always needs to be confirmed by a second Elisa test, and a more specific test. Epidemiology – the study of the incidence, distribution, and control of a disease in a population. Etiology – the cause or origin of a disease. Exposure – the act or condition of coming in contact with, but not necessarily being infected by, a disease-causing agent. Exposure Control Plan – a plan designed to eliminate or minimize employee exposure to bloodbourne pathogens. Exposure Incident – a specific eye, mouth, other mucous membrane, non intact skin, or parental contact with blood or other potentially infectious materials that results from the performance or an employee’s duties. False Negative – incorrect test result indicating that no antibodies are present when they are. GENERAL ORDER SAFETY IN THE WORKPLACE GO – 22 PAGE 14 OF 16 False Positive – incorrect test result indicating that antibodies are present when they are not. HBIG – hepatitis B immune globulin, which is a preparation that provides some temporary protection following exposure to HBV if given within 7 days after exposure. Hepatitis B – a viral infection that affect the liver. The effects of the disease on the liver can range from mild, even unapparent to sever or fatal. High Risk Behavior – a term that describes certain activities that increase the risk of transmitting HIV or HBV. These include anal intercourse, vaginal intercourse without a condom, oral-anal contact, semen in the mouth, sharing intravenous needles, intimate blood contact. HIV – (Human immunodeficiency virus) the cause of AIDS. HIV Disease – the term to describe the spectrum of HIV infection, chronologically described as a progression from asymptomatic seropositive to AIDS. Immune Status – the state of the body’s immune system. Factors affecting immune status include heredity, age, diet and physical and mental health. Immunosuppressed – a condition or state of the body in which the immune system does not work normally. Incubation Period – the time period between infection and appearance of disease symptoms. Infection – a condition or state of the body in which a disease-causing agent has entered it. Intravenous Drugs – drugs injected by needle directly into a vein. Latency – a period when a virus is in the body but is inactive. Mucous Membrane – a moist layer of tissue that lines the mouth, eyes, nostril, vagina, anus, or urethra. Non-intact skin – skin that is chapped, abraded, weeping, or that has rashes or eruptions. Occupational Exposure – reasonably anticipated skin, eye, mucous membrane, or other parenteral materials that may result from the performance of an employees duties. Pathogen – a disease-causing substance. GENERAL ORDER SAFETY IN THE WORKPLACE GO – 22 PAGE 15 OF 16 Pericardial Fluid – A clear fluid contained in the thin, membranous sac that surrounds the heart. Perinatal – happening just before, during, or immediately after birth. Peritoneal Fluid – fluid contained in the membrane lining of the abdominal cavity. Parenteral – piercing mucous membranes or the skin barrier through such events as needle sticks, human bites, cuts, and abrasions. Personal Protective Equipment – is a specialized clothing or equipment worn by an employee for protection against a hazard. General work clothes (uniforms) not intended to function as protection against a hazard and are not considered to be personal protective equipment. Pleural Fluid – fluid contained in the membrane that covers the lung and lines the chest cavity. Pneumonia – a lung infection that has been common among people infected with HIV or diagnosed with AIDS. Prophylaxis – any substance or steps taken to prevent something from happening (for example, vaccines, condoms). Serological Test – any number of tests that are performed on blood. Usually refers to a test that measures antibodies to a virus. Seropositive – a condition in which antibodies to a disease-causing agent are found in the blood; a positive reaction to a blood test. The presence of antibodies indicates that a person has been exposed to the agent. Sterilization – destruction of all microbial life by means of steam, gas, or liquid agents. Source Individual – any individual, living or dead, whose blood or other potentially infectious material may be a source of occupational exposure to the employee. Syndrome – A collection of signs and symptoms that occur together. 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 H.I.V., H.B.V. and other bloodbourne pathogens. Vaccine – a substance that produces or increases immunity and protection against a particular disease. GENERAL ORDER SAFETY IN THE WORKPLACE GO – 22 PAGE 16 OF 16 Window Period – the time it takes the immune system to develop antibodies to the virus after exposure to it.