239 Mass. Reg. 3.12

Current through Register 1523, June 7, 2024

Section 3.12 - Required Precautions Against Bloodborne and Other Pathogens

(1) For purposes of 239 CMR 3.12, the following terms shall have the following meanings:

Blood. Human blood, human blood components, and products made from human blood.

Bloodborne Pathogens. 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) and human immunodeficiency virus (HIV).

Contaminated. The presence or the reasonably anticipated presence of blood or other potentially infectious materials on an item or surface.

Contaminated Laundry. Laundry which has been soiled with blood or other potentially infectious materials.

Occupational Exposure. Actual or reasonably anticipated skin, eye, mucous membrane or parenteral contact with blood or other potentially infectious materials which results or may result from the performance of an employee's duties.

Other Potentially Infectious Materials:

(a) the following human body fluids: semen, vaginal secretions, cerebrospinal fluid, synovial fluid, pleural fluid, pericardial fluid, peritoneal fluid, amniotic fluid, saliva, urine, feces, 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;

(b) any unfixed tissue or organ (other than intact skin) from a human (living or dead); and

(c) HIV-containing cell or tissue cultures, organ cultures, and HIV- or HBV-containing culture medium or other solutions, and blood, organs, or other tissues from experimental animals infected with HIV or HBV.

Personal Protective Equipment. Specialized clothing or equipment worn by an employee for protection against a hazard. General work clothes not intended to function as protection against a hazard are not considered to be personal protective equipment.

Remove. The moving of a dead human body from a home, hospital, or other place of death to a Licensed Funeral Establishment for the purpose of preparing it for burial or cremation.

Ship or Shipment. To convey a dead human body by train, boat, airplane, express or motor freight or other means of transportation either within, into or out of Massachusetts after said body has been prepared for burial or cremation.

Source Individual. Any individual, living or dead, whose blood or other potentially infectious materials may be a source of occupational exposure to the employee. Examples include, but are not limited to, hospital or clinic patients, clients in institutions for the developmentally disabled, trauma victims, clients of drug and alcohol treatment facilities, residents of hospices and nursing homes, human remains, and individuals who donate or sell blood or blood components.

Sterilize. The use of a physical or chemical procedure to destroy all microbial life including highly resistant bacterial endospores.

Transport. To convey a dead human body in a closed hearse or other appropriately registered vehicle used exclusively for the purpose of transporting dead human bodies and/or funeral equipment, either within, into or out of Massachusetts for any purpose other than that referred to in the definitions of 239 CMR 3.12: Remove and Ship or Shipment;

Universal Precautions. An approach to infection control in which all human blood and certain human body fluids are to be treated as if known to be infectious.

(2) As part of their function of being health care responsible, every Type 3 and Type 6 shall adopt all proper means to safeguard the public health, including but not limited to the use of universal precautions during the embalming or preparation of a body, as set forth in 239 CMR 3.12.

(3) Every person, while engaged in removal of a dead human body from the place of death to a Licensed Funeral Establishment, shall be provided with and shall use personal protective clothing and equipment to protect against exposure to bloodborne pathogens.

(a) Disposable OSHA approved gloves shall be worn for barrier protection against contact with blood or other potentially infectious materials. Non-disposable autopsy, kevlar or rubber gloves shall be worn for additional protection if warranted. Non-disposable gloves shall be cleaned and carefully inspected for punctures, tears or other damage after each use. Damaged gloves, whether disposable or non-disposable, shall be replaced immediately. Other soiled clothing shall be removed before the removal of gloves. Gloves shall be carefully removed to avoid skin contact with the exterior of the gloves.

(b) The body being removed shall be enclosed in a body bag or other suitable, sealed container which will prevent leakage or escape of blood or other potentially infectious materials during removal from the place of death to the Licensed Funeral Establishment accepting responsibility for the care and preparation of said body.

(4) Every person, while engaged in actually preparing a dead human body for burial or cremation, shall be provided with and shall use personal protective clothing and equipment to protect against exposure to bloodborne pathogens.

(a) Disposable OSHA approved gloves shall be worn for barrier protection against contact with blood or other potentially infectious materials. Other soiled clothing or equipment shall be removed before the removal of gloves. Gloves shall be carefully removed to avoid skin contact with the exterior of the gloves.

(b) Non-disposable autopsy, kevlar or rubber gloves shall be worn for additional protection if warranted. If non-disposable gloves are used, they shall be cleaned and carefully inspected for punctures, tears or other damage after each use. Damaged gloves shall be replaced immediately. Other soiled clothing or equipment shall be removed before the removal of gloves. Gloves shall be carefully removed to avoid skin contact with the exterior of the gloves.

(c) Disposable face masks shall be worn for barrier protection against sprays of blood or other potentially infectious materials to the mouth or nose. Soiled masks shall be replaced immediately.

(d) Goggles shall be worn for barrier protection against sprays of blood or other potentially infectious materials to the eyes and for vapor protection against exposure to formaldehyde.

(e) Face shields shall be worn for barrier protection against sprays of blood or other potentially infectious materials to the face.

(f) Gowns which are impervious to moisture, are washable or disposable, and are long-sleeved shall be worn for barrier protection against skin contact with chemicals, blood or other potentially infectious materials. Soiled gowns shall be replaced immediately.

(g) Disposable head and shoe covers shall be worn for barrier protection against blood or other potentially infectious materials.

(5) All instruments, appliances and equipment used in the preparation of a dead human body shall be used and maintained in a manner which prevents, insofar as is reasonably possible, conversion of blood or other potentially infectious bodily fluids or materials into aerosols or airborne particles.

(6) Every Licensed Funeral Establishment shall ensure proper disposal of personal protective clothing and equipment. Disposable items contaminated with blood or other potentially infectious materials shall be placed immediately in an appropriately labeled disposal container and removed in accordance with applicable federal, state and local laws and regulations governing hazardous waste disposal. Non-disposable items contaminated with blood or other potentially infectious materials shall be placed immediately in an appropriately labeled laundry container.

(7) No sheets or linens which have come in contact with a dead human body shall be re-used unless they have first been thoroughly laundered and disinfected. No other materials or supplies of any kind which have come in contact with a dead human body shall be used more than once. Contaminated laundry shall be handled as little as possible with a minimum of agitation, shall be bagged or containerized at the location where it was used, and shall not be sorted or rinsed at the location of use. Contaminated laundry shall be placed and transported in bags or containers which are labeled or color-coded in accordance with the applicable requirements of the United States Occupational Safety and Health Administration.

(8) All instruments, appliances and equipment used in the preparation of a dead human body shall be thoroughly cleansed and sterilized in accordance with all applicable state and federal laws and regulations, including but not limited to all applicable regulations of the United States Occupational Safety and Health Administration and the Massachusetts Department of Public Health, immediately at the conclusion of each individual case.

(9) Each preparation room in a Licensed Funeral Establishment shall be equipped with proper and convenient receptacles for refuse, bandages, cotton and other waste materials and supplies, and all such refuse, bandages, cotton and other waste materials shall be disposed of in accordance with all applicable federal, state and local laws governing disposal of hazardous waste.

(10) Whenever a dead human body is transported within, into or out of Massachusetts prior to being embalmed or otherwise prepared for burial or cremation, all persons engaged in the transportation of said body or who may come into physical contact with that body during transportation shall follow the precautions required by 239 CMR 3.12(3).

(11) Whenever a dead human body is transported or shipped within, into or out of Massachusetts after being embalmed or otherwise prepared for burial or cremation, the use of disposable gloves shall be required only for persons who come into actual physical contact with the body itself. Said body shall be transported or shipped in a sealed casket, body bag or other appropriate sealed container which will prevent leakage or escape of blood or other potentially infectious materials during such shipment or transportation.

(12) Notwithstanding the provisions of 239 CMR 3.12(1) through (11), where a body is dead of a disease which has been identified by the Massachusetts Department of Public Health or the Center for Disease Control as one which requires precautions above and beyond those required by 239 CMR 3.12(1) through (11), a Licensed Funeral Establishment and its agents and employees shall follow such additional precautions as may be required or recommended by the Center for Disease Control with respect to said body.

(13) In accordance with the regulations of the United States Occupational Safety and Health Administration ( 29 CFR 1910.1030 ), every Type 3 and Type 6 shall inform all workers performing tasks in and for any Licensed Funeral Establishment, including any trade Type 6s or other workers who are not directly employed by that establishment, about bloodborne pathogen exposure risks associated with specific tasks, how to protect themselves and others from exposure, and the actions to be taken in the event of an exposure incident.

239 CMR 3.12

Amended by Mass Register Issue S1331, eff. 1/27/2017.