In 1993, CAL/OSHA published the Bloodborne Pathogens Rule (Title 8 CCR GISO 5193); the fundamental premise of this rule is an approach to infection control termed Universal Precautions.

The Bloodborne Pathogens Standard (29 CFR, Bloodborne Pathogens. – 1910.1030) applies to all occupational exposure to blood or other potentially infectious materials. Blood means human blood, human blood components, and products made from human blood. 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). Additionally, “Other Potentially Infectious Materials” (OPIM) are included under this standard. OPIM means (1) 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; (2) any unfixed tissue or organ, including cells and cell lines, (other than intact skin), from a human (living or dead); and (3) HIV-containing cell or tissue cultures, organ cultures, and HIV, HBC, or HCV (or other) containing culture medium or other solutions, and blood, organs, or other tissues from experimental animals infected with HIV, HBV or HCV. The above additionally applies to non-human primate materials.

In accordance with the above information, BBP training (considered a Tier II level training) is mandatory and is available under Bloodborne Pathogens (EHS—1600—PROG). This course is entirely web based and requires annual updates (EHS—1601—PROG), also available on the web. To help determine if a worker is at risk for contact with BBP, please use the questions listed below:

If the answer to any of the above questions is yes, then the worker is considered to be at occupational risk of contracting Hepatitis B or other bloodborne pathogens. All workers at risk must take the Bloodborne Pathogen Training. Registration and completion of the appropriate courses are required within the first month of work at Stanford University. Supervisors or PIs who oversee workers that are required to take Bloodborne Pathogens training are themselves required to take Bloodborne Pathogens training even if they will not be potentially exposed to bloodborne pathogens.

Required Training for Laboratory Workers

These courses are designed to ensure compliance with applicable external regulatory requirements.

Aerosol Transmissible Diseases

Aerosol Transmissible Diseases The Stanford University Institutional Aerosol Transmissible Disease Program (Institutional ATD) (https://stanford.io/2k8PrM1) is designed to comply with the California OSHA Aerosol Transmissible Disease Standard (Title 8, Section 5199 https://bit.ly/2jaFDQz). The Institutional ATD addresses issues related to the elimination, minimization and protection of Stanford University personnel to airborne transmissible diseases from both humans and animals (zoonotic diseases). Principal Investigators (PIs) and supervisors should refer to the Institutional ATD as a resource for exposure control background, issues and regulatory procedures.

Research Laboratories

The Stanford University Local Aerosol Transmissible Disease Biosafety Plan- Laboratories (Local ATD-Labs) (https://stanford.io/2CP5p5s) is specifically directed towards research laboratory workers.

The ATD requires laboratories to adopt standard biosafety practices to protect laboratory workers when handling materials containing pathogens that may be spread through aerosols and which can cause serious disease. In addition, the employer is required to develop, implement, and annually review a written ATD Biosafety Plan (Plan). The Stanford University Administrative Panel on Biosafety includes, as part of its charge and following the Biosafety in Microbiological and Biomedical Laboratories (BMBL) (https://www.dir.ca.gov/title8/5199.html), oversight of issues covered within the California OSHA Aerosol Transmissible Disease (ATD) standard. As such, an approved APB protocol shall cover most requirements for laboratories.

Additional information along with the plans and forms are located on the Biosafety webpage under Safety/Medical Monitoring, Aerosol Transmissible Disease Program.

The completed Plan includes the Local ATD document along with approved APB protocol(s). Review the Plan annually or when changes are made (new personnel, agents, SOPs, etc.). The Plan shall be filed in a central location within the laboratory/ work place for all personnel to access and to be made readily available to authorities in event of a regulatory inspection of the facility.

Department of Public Safety

The Stanford University Local Aerosol Transmissible Disease Biosafety Plan – Department of Public Safety (Local ATD – DPS) (https://bit.ly/2CN1CpD) supplements the Stanford University Institutional Aerosol Transmissible Disease Program (https://stanford.io/2k8PrM1) for the DPS. The Local ATD-DPS addresses how to eliminate or minimize exposure to materials containing pathogens that may be spread through aerosols and which can cause serious disease. The Local ATD-DPS addresses health and safety issues specific to the jobs and procedures being used by personnel and constitutes a Tier III training for these topics.

The ATD Standard requires the use of feasible engineering and work practice controls to limit exposure to aerosols, and, when necessary, the provision of personal protective equipment and respirators. The Local ATD – DPS constitutes a written Biosafety Plan (BSP), which shall be implemented and reviewed annually.

Additional information along with the plans and forms are located on the Biosafety webpage under Safety/Medical Monitoring, Aerosol Transmissible Disease Program.

Review the Plan annually or when changes are made (new personnel, procedures, etc.).

The Plan, including training documentation, shall be filed in a central location within the work place for all personnel to access and to be made readily available to authorities in event of a regulatory inspection of the facility.

Zoonotic: On-site and Field Studies

The Stanford University Local Transmissible Diseases Plan – Zoonotic (Local ATD – Zoonotic) (https://stanford.io/2ov8yEv) supplements the Stanford University Institutional Aerosol Transmissible Disease Program for employees with exposure to animals, addressing how to eliminate or minimize exposure to materials containing pathogens that may be spread through aerosols and which can cause serious disease. The Local ATD- Zoonotic addresses health and safety issues specific to the jobs and procedures being used by personnel and constitutes a Tier III training for these topics. The ATD Standard requires the use of feasible engineering and work practice controls to limit exposure to aerosols, and, when necessary, the provision of personal protective equipment and respirators. The Local ATD – Zoonotic constitutes a written Biosafety Plan (BSP), which shall be implemented and reviewed annually.

On-site Research
The Stanford University Administrative Panel on Biosafety (APB) includes, as part of its charge and following the Biosafety in Microbiological and Biomedical Laboratories (BMBL) (https://www.cdc.gov/labs/BMBL.html), oversight of issues covered within the California OSHA Aerosol Transmissible Disease (ATD) standard. As such, an approved APB protocol shall cover requirements for researchers with potential exposure to Zoonotic diseases (ABSL – 2 or above).

The completed Plan includes the Local ATD-Zoonotic document along with approved APB protocol(s). The Plan shall be filed in a central location within the laboratory/work place for all personnel to access and to be made readily available to authorities in the event of a regulatory inspection of the facility.

Additional information along with the plans and forms are located on the Biosafety webpage under Safety/Medical Monitoring, Aerosol Transmissible Disease Program.

Field Studies
For work with wildlife likely containing zoonotic Aerosol Transmissible Pathogens, such as:

• Capture, sampling, transportation or disposal of wild birds or other wildlife for research purposes.
• Disposal of such wildlife remains or waste by employees.

The Local ATD-Zoonotic includes how to establish, implement, and maintain effective procedures for preventing employee exposure to zoonotic aerosol transmissible pathogens; once complete, this shall be kept, along with updates and training records, in a location available for reference by personnel and regulators.

Complete and review the Plan (use information and training materials provided with the Plan) with all applicable employees; document training on sheet provided. Review the Plan annually or when changes are made (new personnel, procedures, etc.). The Plan shall be filed in a central location within the laboratory/work place for all personnel to access and to be made readily available to authorities in event of a regulatory inspection of the facility.

Additional information along with the plans and forms are located on the Biosafety webpage under Safety/Medical Monitoring, Aerosol Transmissible Disease Program.