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Biohazard Remediation Laws, Guidelines and Best Practices
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Biohazard Remediation Laws, Guidelines and Best Practices

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Compliance overview for the biohazard cleaning (aka crime scene cleanup) service industry. Covers national and local regulations, guidelines and industry best practices for medical waste transport and …

Compliance overview for the biohazard cleaning (aka crime scene cleanup) service industry. Covers national and local regulations, guidelines and industry best practices for medical waste transport and disposal, employee safety in biohazard situations, and applicable cases showing fines or sentencing as outcomes of non-compliance. Current as of May 2014.

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  • 1. Biohazard Remediation Regulations Compliance Overview THE BIOHAZARD PEOPLE
  • 2. Legal & Compliance Overview ©Aftermath Services LLC All Rights Reserved 2 There is minimal “direct” licensing of the trauma and crime scene clean-up industry, but it’s actually heavily regulated due to safety, environmental and consumer risks + protections! Employee Safety Environmental Safety Transportation Safety Consumer Protection Home Repair and Improvement Regulatory Agencies Governing the Industry FEDERAL AND STATE OSHA State Environmental Agencies OSHA EPA State Environmental Agencies DOT State Attorney Generals FTC State Attorney Generals FTC State Licensing Boards 1 2 3 4 5 Local & County Health Departments
  • 3. Employee Safety Regulations ©Aftermath Services LLC All Rights Reserved 3 1 • Maintain written protocols on: – Blood-borne pathogens (BBP) – Personal protective equipment (PPE) – Hazardous communications – Respirator protocol (exposure plans) • Train all employees on an annual basis on these protocols, as well as other potential safety exposures such as: – Asbestos Awareness – Lock out / Tag out – Fall Protection / Scaffolding – Lift and Ladder Safety – General Power Tool Safety – Hearing Protection • Provide Hepatitis B vaccinations to all employees at employer’s expense before they are exposed to biological materials – If decline, maintain declination records • Have a medical examination performed on all employees who will wear respirators to ensure they are medically able to work and breathe while wearing the respirator • Provide and enforce use of all appropriate personal protective equipment when exposed to both seen and unseen biological materials, including BBP-rated suits, gloves, booties, and respirators. • Conduct an initial assessment of any hazards or risks to the employee at the job site and make the proper modifications to the work to address such hazards and risks. • Require proper donning and doffing of all PPE to ensure no cross-contamination and no direct contamination to the employee. OSHA Requirements
  • 4. Employee Safety Case Studies ©Aftermath Services LLC All Rights Reserved 4 1 Texas employer fined $137,500 for violations of the Bloodborne Pathogen Standard: (1) failure to utilize universal precautions; (2) inadequate exposure determinations; (3) failure to provide bloodborne pathogen training; (4) failure to provide the Hepatitis B vaccine and post-exposure follow-up to employees potentially exposed; (5) failure to provide regulated waste containers for the disposal of blood and/or blood related products; (6) failure to provide appropriate personal protective equipment; (7) failure to ensure that labels were properly attached, and (8) inadequate documentation regarding training. USDL-OSHA-99-112-8-10 TX: Fined $137,500 Massachusetts employer fined $60,100 for (1) failing to handle regulated medical waste properly (2) failing to provide the Hepatitis B vaccine to employees (3) inadequate exposure control plan (4) failing to provide areas or containers for decontamination or disposal of personal protective equipment (5) failing to provide face shields and appropriate PPE (6) failing to annually evaluate engineering and work practice controls and incorporate changes in exposure control plan, and (7) failing to provide initial BBP training to employees. USDL-OSHA-99-112-8-10 MA: Fined $60,100 Select samples of OSHA issued penalties to non-compliant companies
  • 5. Employee Safety Case Studies ©Aftermath Services LLC All Rights Reserved 5 1 New York employer fined $140,850 for (1) failing to properly disinfect surfaces contaminated with blood or other potentially infectious materials (2) failing to develop and implement a schedule for disinfecting these areas (3) an incomplete and outdated exposure control plan (4) not implementing controls to minimize employees' exposures to sharp objects (5) failing to supply PPE (6) improper disposal of contaminated sharps (7) failing to regularly inspect and decontaminate laundry hampers used to transport contaminated laundry (8) not providing the Hepatitis B vaccine to workers in a timely manner (9) inadequate post-exposure follow-up (10) not maintaining a log of sharps injuries, and (11) inadequate employee training on bloodborne hazards. 04-1739-NEW /BOS 2004-212 NY: Fined $140,850 New York employer fined $65,000 for (1) no written exposure plan (2) failing to provide prompt post-exposure medical treatment at no cost to employees (3) failing to conduct post-exposure blood testing and give employees results and a healthcare professional's opinion in a timely manner, and (4) failing to review and update the company's written exposure control plan USDL 04-323-NEW/BOS 2004-047 NY: Fined $65,000 Select samples of OSHA issued penalties to non-compliant companies
  • 6. Environmental Safety Regulations ©Aftermath Services LLC All Rights Reserved 6 2 • Oversees the packaging, labeling, and handling of regulated medical waste (RMW) to protect employees from blood- borne pathogen exposures. • RMW must be: – Packaged in a red bag of sufficient tensile strength; – Packaged in a secondary rigid container if there is the potential for puncture through the red bag; – All packaging must contain the universal biohazard symbol; and – Packaging must be closable and able to sustain transport without leaking or opening • Employees must wear proper PPE while handling RMW. • Because OSHA mandates packaging of RMW in red biobags, landfills will almost never accept RMW despite any state regulations allowing such disposal. OSHA Regulations
  • 7. Environmental Safety Regulations ©Aftermath Services LLC All Rights Reserved CONFIDENTIAL 7 2 • Packaging, handling, and labeling requirements all similar to OSHA with nuances that vary by state • Generator, transporter, and/or storage licenses required (varies by state) • Training for employees re: packaging, handling, labeling, storing, transporting, disposing of, and manifesting RMW • Written transportation management plans prepared and carried on vehicles and in storage facilities (varies by state) • Specific storage requirements including hazard warnings, segregation, impervious flooring, and refrigeration (varies by state) • Disposal via state-approved methodologies, typically autoclaving or incineration State Environmental Agencies – Medical Waste Management
  • 8. Environmental Safety Regulations ©Aftermath Services LLC All Rights Reserved CONFIDENTIAL 8 2 Manifesting • Requires cradle to grave tracking of medical waste from the point of generation to the point of final destruction. • Typically includes multiple third parties (generator, transporter, transfer station, disposal facility), requiring multiple signatures and complex tracking – Have to match original generation/transport manifest to final proof of destruction which can come weeks/months later • States all vary on the format of the manifest, causing complexity when responding to jobs in multiple states • Most forms require weights, number of boxes, and possibly unique identifying numbers per box • In some states, the customer is considered the generator and required to sign off on the manifest • Must maintain manifests at all points in time while managing RMW • Manifests must be stored on record for 3 years State Environmental Agencies – Medical Waste Management Arizona California
  • 9. Environmental Safety Regulations ©Aftermath Services LLC All Rights Reserved 9 2 • All disinfectants must be properly registered with the EPA. • Disinfectants must be used in strict accordance with the manufacturer’s label (approved by the EPA) in order to substantiate claims of levels of disinfection (i.e. “kills 99.9% of germs). Environmental Protection Agency • Regulates removal and disturbance of lead paint by renovators. • Requires the specific entity to be licensed as a Lead Paint RRP Certified Firm. • Requires each job supervisor to be licensed as a Lead Paint RRP Certified Renovator. • Requires specific notices be provided and certain protocols be followed on each job to prevent unnecessary contamination. Disinfectants Lead Paint
  • 10. Environmental Safety Risks ©Aftermath Services LLC All Rights Reserved 10 2 • How to handle asbestos-containing material (ACM) that is covered in biological material? • Cannot remove or disturb ACM without proper licensing (in-depth training and protocols required; varies by state). • Even the EPA is having difficulty answering how to properly dispose – is it primarily asbestos or regulated medical waste? Improper Disposal of Medical Waste • Hefty fines and clean up costs come with the improper disposal of medical waste (i.e., finding red biobag falling out of a dumpster). • State agencies look for the deep pockets in the chain of custody to pay these costs, regardless of who committed the disposal violation (i.e., negligent third party disposal facility or hauler). • The EPA has issued a consumer warning against the use of ozone generators for indoor air cleaning purposes: http://www.epa.gov/iaq/pubs/ozonegen.html • The amount of ozone necessary to properly clean an affected area causes respiratory damage and illness to those who return to the affected area. • This is mistakenly a common-use practice in the restoration industry and yet clearly goes against EPA recommendations. Asbestos Ozone Generators
  • 11. Environmental Safety Case Studies ©Aftermath Services LLC All Rights Reserved 11 2 • Medical center fined $14,000 by New Mexico Environmental Department because two red biobags ended up in a landfill instead of being properly treated. MA: Fined $39,000 • Massachusetts Dept. of Environmental Protection fined a medical center $39,000 for sending medical waste to a disposal facility not licensed to accept such waste. • Texas medical waste hauler imprisoned under federal and state charges for 6 months, plus 8 years probation, 200 hours of community service, and $11,500 in fines for illegally storing medical waste in unrefrigerated 40-foot trailers and sending falsified destruction documents to the waste generators. NM: Fined $14,000 TX: 6 Mo. Prison, 200 hrs Community Svc, Fined $11,500 Select samples of penalties issued to non-compliant companies
  • 12. Transportation Safety ©Aftermath Services LLC All Rights Reserved 12 3 • Requirements vary by size of transport vehicle (GVW) • RMW considered a hazardous waste by the DOT and Federal Motor Carrier Safety Administration (FMCSA) • Packaging, handling, and labeling specifications for Class 6.2 waste • Specific training for employees transporting waste – Driver requirements further vary by size of transport vehicle Department of Transportation Requirements
  • 13. Consumer Protection Laws ©Aftermath Services LLC All Rights Reserved 13 4 State Consumer Protection Laws Federal Trade Commission • Vary by state (requires 50-state research of laws) • Protect consumer from deceptive and unethical business practices • Can require estimates, written service agreements, and specific contract language such as requirements for jury waivers or arbitration clauses • Enforced by Consumer Protection Bureaus of state Attorneys General’s Offices • Requires 3-Day Cooling Off right for goods or services worth more than $25 sold at a location other than the seller’s regular place of business • Specific contract language, notices, and forms required FEDERAL TRADE COMMISSION
  • 14. Home Repair & Improvement ©Aftermath Services LLC All Rights Reserved CONFIDENTIAL 14 5 State Licensing Boards State Consumer Protection Regulations • Depending on the nature of the work, certain licensing may be required. • Licenses come with state-specific requirements for training, permits, notices, and contract language. (Requires 50-state research.) • Varies by state. • Can require certain pamphlets or notices when performing home repairs. (For example, Illinois requires the Know Your Rights: Home Repair and Remodeling Pamphlet to be given to residential repair consumers.) • Can require specific contract language and estimates.
  • 15. ©Aftermath Services LLC All Rights Reserved 15 Designed specially formulated cleaning agents and coordinated with disinfectant manufacturers regarding EPA compliance Continual research of regulations impacting the industry, at the federal, state, and local level Monitoring of proposed rule changes and regulation updates Auditing internal processes to ensure compliance with all regulations Internal manifest portal to handle complex manifest tracking Review of best practices from noted sources such as NIOSH and the CDC In-House Compliance and Legal Department Substantial internal paperwork to document and record compliance with regulations and best practices through each step of our work How Aftermath Sets the Gold Standard for Compliance
  • 16. At a Glance: Aftermath Services LLC • Trauma cleaning & biohazard removal specialists • Over 17 years experience, thousands of jobs nationwide • Residential, Commercial and Government contracts • 175 employees • Headquarters: Aurora, IL • Trusted, licensed, insured, certified
  • 17. What We Do • Biohazard Remediation & Cleaning • Suicide, Homicide and Trauma • Infectious Disease Decontamination • Unattended Death Cleanup • Filth/Hoarding • Urine/Feces/Animal Contamination • Personal Accidents/Injuries • Specialty Services* • Tear Gas • Industrial and Workplace Accidents (Machinery) • Vehicle and Transportation • Public Facilities - proactive sanitation (jail cell, morgue) • Transient camps and outdoor biohazards * Sorry, we do not clean meth labs
  • 18. How Can We Help Serve Your Community? • We welcome your partnership, feedback and ideas • We offer public education programs, promotional programs and safety training in most regions • Contact information: Emergency Service: 800-366-9923 Informational or non-emergency: 630-551-0735 www.aftermath.com inquiries@aftermath.com ©Aftermath Services LLC All Rights Reserved 18