Biohazard Remediation Laws, Guidelines and Best Practices

Biohazard Remediation Regulations

Compliance OverviewTHE BIOHAZARD PEOPLE

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Legal & Compliance Overview

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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

OSHAState

Environmental Agencies

OSHA EPA

State Environmental

Agencies

DOT

State Attorney Generals

FTC

State Attorney Generals

FTCState

Licensing Boards

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Local & County Health Departments

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Employee Safety Regulations


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• 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

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Employee Safety Case Studies


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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 $60,100Select samples of OSHA issued penalties to non-compliant companies

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Employee Safety Case Studies


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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 $65,000Select samples of OSHA issued penalties to non-compliant companies

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Environmental Safety Regulations


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• 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

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• 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

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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

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• 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

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Environmental Safety Risks


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• 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

http://www.epa.gov/iaq/pubs/ozonegen.html



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Environmental Safety Case Studies


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• 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

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Transportation Safety


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• 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

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Consumer Protection Laws


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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

Notice of Cancellation

Buyer’s Right to Cancel

FEDERAL TRADE COMMISSION

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Home Repair & Improvement


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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

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 DepartmentSubstantial 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

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

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

©Aftermath Services LLC All Rights Reserved 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: 800-366-9923Informational or non-emergency: [email protected]

http://www.aftermath.com/cleanup-biohazard-resources/biohazard-risks-regulations/3rs/