Needlestick in Dental Office Leads to 'Willful' Charge, $76,500 in Fines

OSHA has cited Allcare Dental for alleged willful and serious violations of occupational health standards at its Nashua, N.H., dental office after an employee suffered a needlestick injury. The office faces $76,500 in proposed fines. OSHA's inspection found that the office did not provide the injured employee with no-cost, post-exposure medical evaluation and follow-up, and did not have the blood of the source individual tested, as required under OSHA's bloodborne pathogens standard.

In addition, the office's training program did not include the proper method of removing the capped needle from a syringe, did not explain procedures to be followed in the event of an exposure, and did not provide an opportunity for employees to ask questions about the training. The office's exposure control program also was incomplete and not updated annually, OSHA said. Finally, the office did not use needles with engineered safety devices for user protection.

"OSHA standards spell out the steps that an employer must take to safeguard the health of employees whose duties may involve contact with blood or other potentially infectious materials," said Rosemarie Ohar, OSHA's area director in Concord, N.H.. "It's vital that these safeguards be effectively implemented, communicated and kept up-to-date so that employees and managers know how to both minimize hazards and respond in the event of an exposure."

The agency issued Allcare one willful citation, with a $63,000 proposed fine, for not testing the source individual's blood for infection even after OSHA notified the office that this was required. OSHA defines a willful violation as one committed with plain indifference to or intentional disregard for employee safety and health.

Six serious citations, with $13,500 in proposed fines, have been issued for not providing the post-exposure evaluation and follow-up; not annually reviewing and updating the exposure control program; training deficiencies; and not using sharps with engineered sharps protection. A serious citation is issued when death or serious physical harm is likely to result from a hazard about which the employer knew or should have known.

OSHA's Web site provides more in-depth information about bloodborne pathogens and needlestick prevention on a page dedicated to that topic at www.osha.gov/SLTC/bloodbornepathogens. Allcare has 15 business days from receipt of its citations and fines to meet with OSHA or to contest them before the independent Occupational Safety and Health Review Commission.

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