STANDARDS PRESENTATION Attachment No.

1 TO Page 1 of 21 CALIFORNIA OCCUPATIONAL SAFETY AND HEALTH STANDARDS BOARD PROPOSED STATE STANDARD, TITLE 8, DIVISION 1, CHAPTER 4 TITLE 8 D!"!#!on 1, Cha$te% 4, S&'cha$te% (. )ene%a* In+&#t%, Safet, O%+e%#, A%t!c*e 1-.. A++ ne/ Sect!on 01.1.1 to %ea+ a# fo**o/#

Section 5193.1 Sexually transmitted infections

(a) Scope and Application. (1) Scope. This section covers all wor places in which employees have occupational exposure to !lood!orne patho"ens and#or sexually transmitted patho"ens due to one or more employees en"a"in" in sexual activity with another individual. $or processes covered !y this section include% !ut are not limited to wor activities durin" the production of any film% video% multi&media or other recorded or live representation where one or more employees have occupational exposure. (')Application. (A) This section applies to all employees who have occupational exposure in the wor places descri!ed in su!section (a)(1)% includin" employees who en"a"e in sexual activity and employees who are present when this activity occurs% or who are responsi!le for cleanin" or decontaminatin" the wor area% includin" e(uipment and laundry. ()) This section supercedes the re(uirements of Section 5193 in wor places to which this section applies% except for wor places in which sharps% other than personal care sharps% as defined !elow are used. $here employee activities include intentional parenteral exposure% for example when piercin" the s in or providin" in*ections% the employer shall also comply with re(uirements in Section 5193 re"ardin" the use and disposal of sharps. (+) A producer who solely reproduces and distri!utes material o!tained from another producer in its entirety% and who does not further edit or com!ine the material% need only comply with su!section (")(,). (3) The employer shall provide all safe"uards re(uired !y this section% includin" !arriers% personal protective e(uipment% trainin"% and medical services% at no cost to the employee% at a reasona!le time and place for the employee% and durin" the employee-s wor in" hours. (!) .efinitions. /or purposes of this section% the followin" shall apply0

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STANDARDS PRESENTATION Attachment No. 1 TO Page 2 of 21 CALIFORNIA OCCUPATIONAL SAFETY AND HEALTH STANDARDS BOARD PROPOSED STATE STANDARD, TITLE 8, DIVISION 1, CHAPTER 4 1)arrier2 means a condom or other physical !loc that prevents the passa"e of !lood and 3456&ST5 to another person. 7)lood7 means human !lood% human !lood components% and products made from human !lood. 7)lood!orne 4atho"ens7 means patho"enic microor"anisms that are present in human !lood and can cause disease in humans. These patho"ens include% !ut are not limited to% hepatitis ) virus (8)9)% hepatitis + virus (8+9)% and human immunodeficiency virus (859). 1+.+2 means the :nited States +enters for .isease +ontrol and 4revention% includin" the :.S. 4u!lic 8ealth Service. 1+.482 means the +alifornia .epartment of 4u!lic 8ealth 7+hief7 means the +hief of the .ivision of 3ccupational Safety and 8ealth of the +alifornia .epartment of 5ndustrial ;elations or desi"nated representative. 1+hlamydia2 means the disease caused !y the !acteria Chlamydia trachomatis (+T). 7+ontaminated7 means the presence or the reasona!ly anticipated presence of !lood or 3456&ST5 on a surface or in or on an item. 7+ontaminated <aundry7 means laundry which has !een soiled with !lood or 3456&ST5 or which may contain sharps. 1+onsortium 4<8+42 means a 4<8+4 who provides medical services on !ehalf of one or more employers in accordance with this standard and who meets the re(uirements in su!section (e)(1)()). 7.econtamination7 means the use of physical or chemical means to remove% inactivate% or destroy patho"ens on a surface or item to the point where they are no lon"er capa!le of transmittin" infectious particles and the surface or item is rendered safe for handlin"% use% or disposal. .econtamination includes procedures re"ulated !y 8ealth and Safety +ode Section 11='>5. 7?n"ineerin" +ontrols7 means controls (e.".% sharps disposal containers% !arrier protection such as condoms% simulation of sexual acts) that isolate or remove exposure ha@ards to the !lood!orne patho"ens and#or sexually transmitted infectious patho"ens or other potentially infectious materials (3456&ST5) from the wor place.

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STANDARDS PRESENTATION Attachment No. 1 TO Page 1 of 21 CALIFORNIA OCCUPATIONAL SAFETY AND HEALTH STANDARDS BOARD PROPOSED STATE STANDARD, TITLE 8, DIVISION 1, CHAPTER 4 7?xposure 5ncident7 means a specific eye% mouth% other mucous mem!rane% non&intact s in% or parenteral contact with !lood or 3456&ST5 that results from the performance of an employeeAs duties. ?xposure 5ncident2 does not include oral contact with 3456&ST5 or "enitals if the employer has met the criteria for the exception to su!section (d)('). 1Benital herpes2 means the disease caused !y herpes simplex virus when it occurs in or on the "enitals. 1Benitals2 means the penis% vulva% va"ina% urethra% and anus% and ad*acent structures and mucous mem!ranes. 1Bonorrhea2 means the disease caused !y the !acteria Neisseria gonorrhoeae (B+). 18A92 means hepatitis A virus 78)97 means hepatitis ) virus. 78+97 means hepatitis + virus. 78597 means human immunodeficiency virus. 18492 means human papilloma virus <ocal health officer (<83). The health officer for the local *urisdiction responsi!le for receivin" and#or sendin" reports of communica!le diseases% as defined in Title 1>% ++;. Cote0 Title 1>% Section '5DD re(uires that reports !e made to the local health officer for the *urisdiction where the patient resides. 7C53S87 means the .irector of the Cational 5nstitute for 3ccupational Safety and 8ealth% :.S. .epartment of 8ealth and 8uman Services% or desi"nated representative. 73ccupational exposure2 means reasona!ly anticipated contact of the s in% eye% mouth% "enitals or other mucous mem!ranes with "enitals of another person% or with !lood or 3456EST5% that may result from the performance of an employeeAs duties. Simulated activities% in which there is no potential for actual contact of a person-s eyes% s in% mouth or mucous mem!ranes with a source individual-s "enitals or with !lood or 3456EST5% are not considered to create occupational exposure. 13ther potentially infectious materials F sexually transmitted 5nfections2 (3456EST5) means !odily fluids and other su!stances that may contain and transmit sexually transmitted patho"ens. These fluids include% !ut are not limited to% pre&e*aculate% e*aculate% semen% va"inal secretions% fecal matter and rectal secretions% secretions from

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STANDARDS PRESENTATION Attachment No. 1 TO Page 4 of 21 CALIFORNIA OCCUPATIONAL SAFETY AND HEALTH STANDARDS BOARD PROPOSED STATE STANDARD, TITLE 8, DIVISION 1, CHAPTER 4 wounds or sores that are potentially infected with sexually transmitted patho"ens% and any other !odily fluid when visi!ly contaminated with !lood or all !odily fluids in situations where it is difficult or impossi!le to differentiate !etween !odily fluids. 74arenteral +ontact7 means piercin" mucous mem!ranes or the s in !arrier throu"h such events as intentional piercin"% needlestic s% human !ites% cuts% and a!rasions. 14ersonal care sharps2 means ra@ors% scissors% and similar tools used !y an individual to perform cosmetic procedures on herself or himself% such as shavin". 4ersonal care sharps do not include tools intended for piercin" the s in% or for the purpose of applyin" tattoos or other permanent cosmetics. 74ersonal 4rotective ?(uipment7 is any "arment% device (such as a condom)% or e(uipment used to prevent contact of an employee-s eyes% s in% mucous mem!ranes% or "enitals with the !lood or 3456&ST5 of another. 14hysician or other <icensed 8ealth +are 4rofessional2 (4<8+4) means an individual whose le"ally permitted scope or practice (i.e.% license% re"istration% or certification) allows him or her to independently provide% or !e dele"ated the responsi!ility to provide% some or all of the health care services re(uired !y this section. 14roducer2 means an employer who arran"es for% finances% directs% records% !roadcasts% displays% or edits a scene or com!ination of scenes. 14roduction2 means a depiction% recorded or live% in which one or more employees en"a"e in sexual activity. A production may consist of one or several scenes. 1Scene2 means a depiction% recorded or live% in which one or more employees en"a"e in sexual activity% and which is a continuous portion of a production. 1Set2 means the area in which the performance occurs. 1Sexual activity2 means actual contact of an employee-s "enitals% eyes% or mouth with the "enitals or 3456&ST5 of another person 1Sexually Transmitted 5nfection2 (ST5) means any infection spread !y sexual contact% includin" !ut not limited to 859#A5.S% "onorrhea% syphilis% chlamydia% hepatitis )% "enital herpes% and human papillomavirus (849) infection. 1Sexually Transmitted 4atho"en2 (ST4) is a patho"en transmitted !y sexual contact% includin" !ut not limited to human immunodeficiency virus (859)% Neisseria gonorrhoeae

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STANDARDS PRESENTATION Attachment No. 1 TO Page 0 of 21 CALIFORNIA OCCUPATIONAL SAFETY AND HEALTH STANDARDS BOARD PROPOSED STATE STANDARD, TITLE 8, DIVISION 1, CHAPTER 4 (GC)% Treponema pallidum% Chlamydia trachomatis (CT)% hepatitis ) virus (8)9)% hepatitis + virus (8+9)% herpes simplex virus (8S9)% and human papillomavirus (849). 1Source 5ndividual7 means an employee or other individual whose !lood or 3456&ST5 may !e a source of occupational exposure to an employee. 1Syphilis2 means the disease caused !y infection with Treponema pallidum. 7:niversal 4recautions7 is an approach to infection control. Accordin" to the concept of :niversal 4recautions% all human !lood and certain human !odily fluids are treated as if nown to !e infectious. 7$or 4ractice +ontrols7 means controls that reduce the li elihood of exposure !y definin" the manner in which a tas is performed (e.".% procedures for chan"in" condoms% use of lu!ricant). (c) ?xposure 4revention and ;esponse. (1) ?xposure control plan (A) ?ach employer havin" any employee(s) with occupational exposure as defined !y su!section (!) of this section shall esta!lish% implement% and maintain an effective ?xposure +ontrol 4lan which is desi"ned to eliminate or minimi@e employee exposure and which is also consistent with Section 3'D3. ()) The ?xposure +ontrol 4lan shall !e in writin" and shall contain at least the followin" elements0 1. An exposure determination that includes the followin"0 a. A list of the tas s or activities that involve or may involve occupational exposure to !lood or 3456EST5 if control measures are not implemented. This determination shall !e made without re"ard to the use of personal protective e(uipment. !. A list of the *o! classifications in which all employees have occupational exposure c. A list of the *o! classifications in which some employees have occupational exposure. '. The control measures that will !e used for each tas or activity% or "roup of similar tas s or activities% as re(uired !y su!section (d). 3. The procedures for the evaluation of circumstances surroundin" exposure incidents as re(uired !y su!section (e).

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STANDARDS PRESENTATION Attachment No. 1 TO Page 7 of 21 CALIFORNIA OCCUPATIONAL SAFETY AND HEALTH STANDARDS BOARD PROPOSED STATE STANDARD, TITLE 8, DIVISION 1, CHAPTER 4 ,. The schedule and method of implementation for medical services% includin" provision of vaccinations% periodic medical monitorin"% and post&exposure evaluation as re(uired !y su!section (e). 5. The procedures for providin" trainin"% in accordance with su!section (f) G. The procedures for record eepin" in accordance with su!section ("). >. An effective procedure for o!tainin" the active involvement of employees in reviewin" and updatin" the exposure control plan. (+) ?ach employer shall ensure that a copy of the ?xposure +ontrol 4lan is availa!le at the wor site at all times that employees are present. (.) The ?xposure +ontrol 4lan shall !e reviewed and updated at least annually and whenever necessary to ensure that effective control measures are implemented for every tas involvin" occupational exposure. ?mployees shall !e involved in the plan review. (?) The plan shall also !e reviewed after each exposure incident to determine the cause of the incident and to determine whether any chan"e in control measure is necessary. (/) The ?xposure +ontrol 4lan shall !e made availa!le to the +hief or C53S8 or their respective desi"nee% upon re(uest% for examination and copyin". (d) 6ethods of +ompliance. (1) Beneral. :niversal precautions shall !e o!served to prevent contact with !lood or 3456EST5. :nder circumstances in which differentiation !etween !odily fluid types is difficult or impossi!le% all !odily fluids shall !e considered potentially infectious materials. (') Beneral control measures. ?ach employer is re(uired to maintain en"ineerin" and wor practice controls sufficient to protect employees from exposure to !lood and#or 3456&ST5. $hen simulation of sexual activity usin" actin"% production% and postproduction techni(ues are not used% or do not prevent all occupational exposure% all of the followin" control measures are re(uired0 (A) ?*aculation onto surfaces other than another person-s "enitals% eyes% mouth or other mucous mem!ranes or non&intact s in. ()) 4rovision of and re(uired use of condoms or other protective !arriers to prevent "enital contact of one person with the "enitals of another personH (+) The provision of condom&safe water&!ased or silicone&!ased lu!ricants to facilitate the use of condomsH (.) 4rovision of and re(uired use of condoms or other protective !arriers to prevent "enital and oral contact with the !lood or 3456EST5 of another personH (?) The employer shall develop and implement wor practices for the use of condoms and other !arriers% in accordance with Appendix ).

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STANDARDS PRESENTATION Attachment No. 1 TO Page ( of 21 CALIFORNIA OCCUPATIONAL SAFETY AND HEALTH STANDARDS BOARD PROPOSED STATE STANDARD, TITLE 8, DIVISION 1, CHAPTER 4

?xception to su!section (d)(')0 :ntil Ianuary 1% 'D1=% employers may use alternate procedures in lieu of usin" condoms or other !arrier protection to prevent oral contact with the 3456&ST5 or "enitals of another person. The alternate procedures shall include all of the followin"0 1. ?sta!lish and implement control measures in the exposure control plan for oral contact with the 3456&ST5 or "enitals of another person. These measures shall include the employer-s en"ineerin" and wor practice controls% procedures for use of personal protective e(uipment% and any other measures used to reduce the ris of transmission of !lood!orne patho"ens and other sexually transmitted patho"ens. '. ?ach exposed individual must have either completed the vaccine series for hepatitis )% human papilloma virus% and hepatitis A% or !e current in receivin" the vaccine doses. 3. ?ach exposed individual must have !een medically evaluated for the purpose of these alternate procedures !y a 4<8+4 in accordance with su!section (e)(G)% and must have a current physician-s opinion permittin" oral contact without !arrier protection. (3) 3ther 4rohi!ited 4ractices. (A) 4ersonal care sharps shall not !e reused on a different individual% unless the items have !een decontaminated in accordance with Section 5193. ()) 3!*ects that have !ecome contaminated with !lood or 3456EST5 at one anatomic site shall not !e reused on another anatomic site% or on another person% unless the o!*ect has !een appropriately decontaminated. (+) )ro en Blassware. )ro en "lassware which may !e contaminated shall not !e pic ed up directly with the hands. 5t shall !e cleaned up usin" mechanical means% such as a !rush and dust pan% ton"s% or forceps. (.) The contents of sharps containers shall not !e accessed unless properly reprocessed or decontaminated. (?) Sharps containers shall not !e opened% emptied% or cleaned manually or in any other manner which would expose employees to the ris of sharps in*ury. (,) Specific +ontrol 6easures (A) +ontaminated Sharps 1. The use% disposal% and disinfection of all contaminated sharps other than !ro en "lass and personal care sharps shall !e in accordance with section 5193. '. 5mmediately% or as soon as possi!le after use% all contaminated personal care sharps and !ro en "lass shall !e disposed of in appropriate containers.

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STANDARDS PRESENTATION Attachment No. 1 TO Page 8 of 21 CALIFORNIA OCCUPATIONAL SAFETY AND HEALTH STANDARDS BOARD PROPOSED STATE STANDARD, TITLE 8, DIVISION 1, CHAPTER 4 These containers shall !e ri"id% puncture resistant% lea proof on the sides and !ottom% and capa!le of !ein" completely closed. These containers shall !e closed and sealed prior to disposal. ()) +ontaminated $aste. Con&sharps waste contaminated with !lood or 3456E ST5 shall !e disposed of in plastic !a"s or other impermea!le containers% which are closa!le% constructed to contain all contents and prevent lea a"e durin" handlin"% stora"e% transport or shippin"% and closed prior to removal. 5f outside contamination of a container of contaminated waste occurs% it shall !e placed in a secondary container that meets the re(uirements of this su!section. (+) +leanin" and .econtamination of the $or site. 1. The employer shall ensure that the wor site is maintained in a clean and sanitary condition. '. The employer shall provide plastic coverin"s or other disposa!le materials to facilitate cleanin" of the wor area. 3. The employer shall determine and implement appropriate written methods and schedules for cleanin" and decontamination of the wor site. ,. The method of cleanin" or decontamination used shall !e effective and shall !e appropriate for the type of surface or e(uipment to !e treated% the type of soil or contamination present% and the tas s or procedures !ein" performed in the area. 5. All e(uipment and environmental and wor surfaces shall !e cleaned and decontaminated after contact with !lood or 3456EST5% at the end of each scene% and no later than at the end of each day of production. G. ?mployers shall ensure that cleanin" and disinfection methods that are used for sex toys and other o!*ects that may have contact with an employee-s "enitals% eyes% s in% or other mucous mem!ranes do not cause irritation or other harm to the employee. >. ;eceptacles. All !ins% pails% cans% and similar receptacles intended for reuse which have a reasona!le li elihood for !ecomin" contaminated with !lood or 3456EST5 shall !e inspected and decontaminated on a re"ularly scheduled !asis and cleaned and decontaminated immediately or as soon as feasi!le upon visi!le contamination. (.) 8y"iene. 1. ?mployers shall provide hy"iene facilities% includin" toilet facilities% washin" facilities% shower facilities% and chan"e rooms meetin" the re(uirements of Title = Article 9. '. The employer shall esta!lish wor practices to ensure that !ody areas contaminated with !lood or 3456E ST5 are cleaned !etween sexual acts with the same or different persons.

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STANDARDS PRESENTATION Attachment No. 1 TO Page . of 21 CALIFORNIA OCCUPATIONAL SAFETY AND HEALTH STANDARDS BOARD PROPOSED STATE STANDARD, TITLE 8, DIVISION 1, CHAPTER 4 3. The employer shall ensure that soaps and other cleaners are not irritatin" to or otherwise dama"in" of the employee-s s in or mucous mem!ranes. (?) <aundry 1. The employer shall ensure that contaminated laundry is handled as little as possi!le% and is !a""ed at the site of usa"e. '. The employer shall ensure that employees who have contact with contaminated laundry wear protective "loves. (/) 4ersonal 4rotective ?(uipment 1. $here occupational exposure remains after institution of en"ineerin" and wor practice controls% the employer shall provide% at no cost to the employee% appropriate personal protective e(uipment such as% !ut not limited to% condoms% "loves for cleanin"% and% if contact of the eyes with 3456&ST5 is reasona!ly anticipated% eye protection. 4ersonal protective e(uipment will !e considered 7appropriate7 only if it prevents !lood or 3456EST5 from passin" throu"h to or reachin" the employeeAs eyes% mouth% or other mucous mem!ranes% or non&intact s in under normal conditions of use and for the duration of time which the protective e(uipment will !e used. '. The employer shall ensure that the employee uses appropriate personal protective e(uipment. The employer shall ensure that appropriate personal protective e(uipment in the appropriate si@es is readily accessi!le at the wor site or is issued to employees. 8ypoaller"enic materials% includin" /.A approved non&latex condoms% shall !e readily accessi!le to those employees who are aller"ic to the e(uipment normally provided. 3. The employer shall clean% launder% and#or dispose of personal protective e(uipment re(uired !y su!section (d) of this standard% at no cost to the employee. The employer shall repair or replace personal protective e(uipment as needed to maintain its effectiveness% at no cost to the employee. ,. 5f a "arment(s) is penetrated !y !lood or 3456&ST5% the "arment(s) shall !e removed immediately or as soon as feasi!le. All personal protective e(uipment shall !e removed prior to leavin" the wor area. $hen personal protective e(uipment is removed% it shall !e placed in an appropriately desi"nated area or container for stora"e% washin"% decontamination or disposal. 5. Bloves. Bloves shall !e worn when employees are cleanin" and decontaminatin" wor areas% and when handlin" contaminated laundry. Bloves shall !e appropriate for the use% and shall !e provide protection from chemicals that can cause s in irritation or other harm% in accordance with Section 33=,.

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STANDARDS PRESENTATION Attachment No. 1 TO Page 1- of 21 CALIFORNIA OCCUPATIONAL SAFETY AND HEALTH STANDARDS BOARD PROPOSED STATE STANDARD, TITLE 8, DIVISION 1, CHAPTER 4 G. )arrier protection for the eye% s in% and mucous mem!ranes. The employer shall not permit e*aculation onto the employee-s eyes% non&intact s in% mouth or other mucous mem!ranes. 5f wor activities may expose the employee-s eyes% non&intact s in% or mucous mem!ranes to !lood or 3456EST5% the employer shall provide condoms or other suita!le !arrier protection. E8ce$t!on to #&'#ect!on 4+6446496 :nt!* ;an&a%, 1, 2-18, $e%#ona* $%otect!"e e<&!$ment nee+ not 'e &#e+ fo% contact of the mo&th /!th OPI=3STI !f the em$*o,e% com$*!e# /!th the con+!t!on# of the e8ce$t!on to #&'#ect!on 4+6426. (e) 6edical services and post exposure follow&up. (1) Beneral. (A) The employer shall esta!lish% implement and maintain a system of medical services and post&exposure evaluation and follow&up for all employees who have occupational exposure. All medical services re(uired !y this section shall !e provided at no cost to the employee% made availa!le at a reasona!le time and place and durin" the employee-s wor in" hours% performed !y or under the supervision of a physician or other licensed health care professional (4<8+4)% and provided accordin" to the re(uirements of this Section% and the recommendations of the +.+ and +.48 current at the time these evaluations and procedures ta e place. ()) The employer shall instruct the 4<8+4 to report communica!le diseases to the local health department as re(uired !y Title 1>% +alifornia +ode of ;e"ulations% and for occupational in*uries or illnesses% to complete and file the .octor-s /irst ;eport of 3ccupational 5n*ury or 5llness in accordance with Sections 1,DD3 and 1,DDG. (+) ?mployers may contract with a consortium 4<8+4 to provide some or all of these services% and may ma e arran"ements to share costs with other employers so lon" as none of these costs are !orne !y employees. The employer(s) shall only contract with a consortium 4<8+4 who a"rees to do all of the followin"0 1. +omply with su!section (e)(1)()). '. +ooperate with the local health officer to investi"ate and control communica!le diseases. 3. 6aintain the contact information for each contractin" employer% and provide that information to the +hief% the local health officer% and the +alifornia .epartment of 4u!lic 8ealth upon re(uest. (.) $hen a consortium 4<8+4 is actin" as the evaluatin" health care professional after an exposure incident% the employer shall advise the employee that the employee may refuse to consent to post&exposure evaluation and follow& up from the 4<8+4. $hen consent is refused% the employer shall ma e

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STANDARDS PRESENTATION Attachment No. 1 TO Page 11 of 21 CALIFORNIA OCCUPATIONAL SAFETY AND HEALTH STANDARDS BOARD PROPOSED STATE STANDARD, TITLE 8, DIVISION 1, CHAPTER 4 immediately availa!le to exposed employees a confidential medical evaluation and follow&up from a different 4<8+4. (?) The employer shall ensure that all la!oratory tests are conducted !y an accredited la!oratory at no cost to the employee. (') 9accinations. (A) Beneral. The employer shall provide 8)9% 8A9 and 849 vaccine to all employees who have occupational exposure. ()) ?ach vaccination series re(uired !y this section shall !e made availa!le to all employees who have occupational exposure% unless the employee has previously received the complete vaccine series. The vaccine shall !e made availa!le after the employee has received the trainin" re(uired in su!section (f) (')(B)9% and prior to the employee-s initial assi"nment. 9accines need not !e provided if the 4<8+4 determines that the vaccine is contraindicated for medical reasons. (+) 8)9 vaccine need not !e provided if serolo"ical testin" reveals that the employee is immune. 8owever% the employer shall not ma e participation in a prescreenin" pro"ram a prere(uisite for receivin" 8)9 vaccine. (.) 849 vaccine shall !e provided to each employee for which current +.+ "uidelines recommend 849 vaccination. (?) 5f the employee initially declines an offered vaccine% !ut at a later date while still covered under the standard decides to accept the vaccination% the employer shall ma e availa!le the vaccine availa!le at that time. (/) The employer shall assure that employees who decline to accept 8)9 vaccination offered !y the employer si"n the statement in Appendix A&1. The employer shall assure that employees who decline to accept 849 vaccination offered !y the employer si"n the statement in Appendix A&'. The employer shall assure that employees who decline to accept 8A9 vaccination offered !y the employer si"n the statement in Appendix A&3. (B) 5f a routine !ooster dose(s) of 8)9% 8A9% or 849 vaccine is recommended !y the +.+ or +.48 at a future date% such !ooster dose(s)shall !e made availa!le in accordance with this su!section. (3) 4ost&exposure ?valuation and /ollow&up. /ollowin" a report of an exposure incident% the employer shall ma e immediately availa!le to the exposed employee a confidential medical evaluation and follow&up% includin" at least the followin" elements0 (A) The employer shall document the route(s) of exposure% and the circumstances under which the exposure incident occurred.

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STANDARDS PRESENTATION Attachment No. 1 TO Page 12 of 21 CALIFORNIA OCCUPATIONAL SAFETY AND HEALTH STANDARDS BOARD PROPOSED STATE STANDARD, TITLE 8, DIVISION 1, CHAPTER 4 ()) The employer shall identify and document the source individuals involved in the exposure incident% unless the employer can esta!lish that identification is infeasi!le or prohi!ited !y state or local law. The employer shall provide the followin" medical services0 1. The !lood of all source individuals shall !e collected and tested as soon as feasi!le and after consent is o!tained in order to determine 8)9% 8+9% 859% and syphilis infectivity. 5f consent is not o!tained% the employer shall esta!lish that le"ally re(uired consent cannot !e o!tained. $hen one of the source individuals is already nown to !e infected with 8)9% 8+9% or 859% testin" for that individualAs nown 8)9% 8+9% or 859 status need not !e repeated. '. 5f an employee consents to !aseline !lood collection% !ut does not "ive consent at that time for 859 serolo"ic testin"% the sample shall !e preserved for at least 9D days. 5f% within 9D days of the exposure incident% the employee elects to have the !aseline sample tested% such testin" shall !e done as soon as feasi!le. 3. ?ach source individual shall !e tested for other ST5-s !y urine% and !y culture swa!s of appropriate areas% !ased upon the routes of exposure. ,. $hile "uardin" the source individual-s anonymity% results of each source individualAs testin" shall !e made availa!le to the other exposed employees to the extent permitted !y law% and the employees shall !e informed of applica!le laws and re"ulations concernin" disclosure of the identity and infectious status of the source individual. 5. Additional collection and testin" shall !e made availa!le as recommended !y the :.S. 4u!lic 8ealth Service and for non&!lood!orne ST5s the +.48 or local health officer. (+) The employer shall provide for post&exposure prophylaxis for exposed employees% when medically indicated% as recommended !y the :.S. 4u!lic 8ealth Service and% for non&!lood!orne ST5s% the +.48 or local health officer. (.) The employer shall provide for counselin" of employees% and evaluation of reported employee illnesses. (?)The employer shall investi"ate all exposure incidents to determine whether control measures were in place% whether procedures for exposure incidents were followed% and whether control measures need to !e modified to prevent further incidents. These records shall !e created and maintained in accordance with su!section (")(3)()). (/) The employer shall ensure that all exposure incidents% post&exposure evaluations% and employee infections and illnesses are recorded in accordance with Title =% +alifornia +ode of ;e"ulations% .ivision 1% +hapter >.

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STANDARDS PRESENTATION Attachment No. 1 TO Page 11 of 21 CALIFORNIA OCCUPATIONAL SAFETY AND HEALTH STANDARDS BOARD PROPOSED STATE STANDARD, TITLE 8, DIVISION 1, CHAPTER 4 (,) 5nformation 4rovided to the 4<8+4 (A) The employer shall ensure that the healthcare professional responsi!le for the employeeAs hepatitis )% hepatitis A% and#or 849 vaccination is provided a copy of this re"ulation. ()) The employer shall ensure that the 4<8+4 evaluatin" an employee after an exposure incident is provided the followin" information0 1. A copy of this re"ulationH '. A description of the exposed employeeAs duties as they relate to the exposure incidentH 3. .ocumentation of the route(s) of exposure and circumstances under which exposure occurred% as re(uired !y su!section (ef)(3)(A)H ,. The contact information for any 4<8+4 nown to the employer to have performed testin" on a source individualH 5. All medical records relevant to the appropriate treatment of the employee includin" vaccination status which are the employerAs responsi!ility to maintain% as re(uired !y su!section (")(1)())'. (5) 4<8+4-s $ritten 3pinion. The employer shall o!tain and provide the employee with a copy of the evaluatin" healthcare professionalAs written opinion within 15 days of the completion of the evaluation. (A) The healthcare professionalAs written opinion for hepatitis ) virus and#or human papilloma virus vaccination shall !e limited to whether the vaccination(s) is indicated for an employee% and if the employee has received such vaccination. ()) The healthcare professionalAs written opinion for post&exposure evaluation and follow&up shall !e limited to the followin" information0 1. That the employee has !een informed of the results of the evaluationH and '. That the employee has !een told a!out any medical conditions resultin" from exposure to !lood or 3456EST5 which re(uire further evaluation or treatment. 3. Any recommended limitations on the employee-s activities in relationship to this standard. (+) All other findin"s or dia"noses shall remain confidential and shall not !e included in the written report. (G) 6edical surveillance re(uirements for alternate control measures. (A) The employer shall ensure that each potential source individual that will not use !arrier protection as descri!ed in the exception to su!section (d)(') is provided with a pre&exposure evaluation that includes the followin" services0 1. 4rovision of 8)9% 8A9% and 849 vaccine% unless the employee is already fully vaccinated% or another dose is not indicated at that time. '. Testin" of the !lood !y .CA 4+; for 859 virus

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STANDARDS PRESENTATION Attachment No. 1 TO Page 14 of 21 CALIFORNIA OCCUPATIONAL SAFETY AND HEALTH STANDARDS BOARD PROPOSED STATE STANDARD, TITLE 8, DIVISION 1, CHAPTER 4 3. Testin" of urine and !y swa! of the pharynx% anus and va"ina for +hlamydia and "onorrhea ,. 4hysical examination for si"ns of ST5s ()) The services descri!ed in su!section (f)(G)(A) shall !e provided within the two wee period immediately precedin" the activity. (+) The 4<8+4 that performs or supervises these surveillance activities shall provide the individual with a written opinion that includes the followin"0 1. The procedures descri!ed in su!section (e)(G)(A) were completed. '. The date of the evaluation 3. $hether there are any limitations on the individual-s activities in relation to su!section (d)('). (>) 6edical ;ecord eepin". 6edical records re(uired !y this standard shall !e maintained in accordance with su!section (")(1) of this section. (f) +ommunication of 8a@ards to ?mployees. (1) <a!els and si"n. $here sharps% other than personal care sharps% are used the employer shall comply with Section 5193(")(1). (') 5nformation and Trainin" (A)?mployers shall ensure that all employees with occupational exposure participate in a trainin" pro"ram which must !e provided at no cost to the employee and durin" wor in" hours. ()) Trainin" shall !e provided as follows0 1. At or prior to the time of initial assi"nment to tas s where occupational exposure may ta e place and prior to performance of those tas s. '. At least annually thereafter. 3. /or employees who have received trainin" on !lood!orne patho"ens and ST5s in the year precedin" the effective date of the standard% only trainin" with respect to the provisions of the standard which were not included need !e provided. (+) Annual trainin" for all employees shall !e provided within one year of their previous trainin". (.) The person conductin" the trainin" shall !e nowled"ea!le in the su!*ect matter covered !y the elements contained in the trainin" pro"ram as it relates to the wor place that the trainin" will address. (?) ?mployers shall conduct a safety meetin" prior to any employee en"a"in" in sexual activity. The employer shall provide information to all individuals who will participate in the activity% or the production of any recordin"s or other

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STANDARDS PRESENTATION Attachment No. 1 TO Page 10 of 21 CALIFORNIA OCCUPATIONAL SAFETY AND HEALTH STANDARDS BOARD PROPOSED STATE STANDARD, TITLE 8, DIVISION 1, CHAPTER 4 representations of the activity% re"ardin" the control measures to !e used% and specific information re"ardin" the employer-s procedures for emer"encies% exposure incidents% and post&exposure evaluation and follow&up. (/) 6aterial appropriate in content and voca!ulary to educational level% literacy% and lan"ua"e of employees shall !e used. (B) The trainin" pro"ram shall contain% at a minimum% the followin" elements0 1. +opy and ?xplanation of Standard. An accessi!le copy of the re"ulatory text of this standard and an explanation of its contentsH '. ?pidemiolo"y% Si"ns% and Symptoms. A "eneral explanation of the epidemiolo"y% si"ns% and symptoms of !lood!orne diseases and ST5s. This shall include how employees may perform self&examination for si"ns of ST5s and reco"ni@e those si"ns in partners. This trainin" shall also include the information that many ST5s may have no symptoms or visi!le si"ns even thou"h they may !e transmitted. 3. 6odes of Transmission. An explanation of the modes of transmission of !lood!orne patho"ens and ST5s and the possi!le health effects that may result from treated and untreated infections ,. ?mployerAs ?xposure +ontrol 4lan. An explanation of the employerAs exposure control plan and the means !y which the employee can o!tain a copy of the written planH 5. ;is 5dentification. An explanation of the appropriate methods for reco"ni@in" tas s and other activities that may involve exposure to !lood and 3456&ST5H G. 6ethods of +ompliance. An explanation of the use and limitations of methods that will prevent or reduce exposure% includin" appropriate en"ineerin" controls% administrative or wor practice controls% and personal protective e(uipment. $here the employer is utili@in" alternate control measures to comply with su!section (d)(')% the employer shall explain how those procedures are implemented% includin" the vaccination and medical surveillance re(uirements. >. .econtamination and .isposal. 5nformation on the types% proper use% location% removal% handlin"% decontamination% and disposal of laundry% personal protective e(uipment% sex toys% and other contaminated itemsH =. 4ersonal 4rotective ?(uipment. An explanation of the !asis for selection of personal protective e(uipmentH 9. 9accination. 5nformation on the hepatitis ) virus (8)9) vaccine% hepatitis A virus (8A9) and human papilloma virus (849) vaccine % includin" information on their efficacy% safety% method of administration% the !enefits of !ein" vaccinated% and that the vaccines and vaccinations will !e offered free of char"eH

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STANDARDS PRESENTATION Attachment No. 1 TO Page 17 of 21 CALIFORNIA OCCUPATIONAL SAFETY AND HEALTH STANDARDS BOARD PROPOSED STATE STANDARD, TITLE 8, DIVISION 1, CHAPTER 4 1D. ?mer"ency. 5nformation on the appropriate actions to ta e and persons to contact in an emer"ency involvin" !lood or 3456EST5 H 11. ?xposure 5ncident. An explanation of the procedure to follow if an exposure incident occurs% includin" the method of reportin" the incident% the medical follow&up that will !e made availa!leH if sharps other than personal care sharps are used% this shall include how the information re(uired !y Section 5193 (c)(') will !e collected. 1'. 4ost&?xposure ?valuation and /ollow&:p. 5nformation on the post& exposure evaluation and follow&up that the employer is re(uired to provide for the employee followin" an exposure incidentH 13. Si"ns and <a!els. An explanation of the si"ns and la!els and#or color codin" re(uired !y su!section (f")(1)H and (8) 5nteractive Juestions and Answers. An opportunity for interactive (uestions and answers with the person conductin" the trainin" session. (5) .ue to the intermittent nature of employment in this industry% one or more employers may arran"e to conduct trainin" as a consortium on the "eneral elements of su!section (f)(')(B)% so lon" as each employer ensures that the trainin" provided meets the followin" conditions0 1. ?ach individual who will participate in a production is trained prior to their first assi"nment involvin" occupational exposure% and at least annually thereafter. '. There is an opportunity for interactive (uestions and answers durin" each part of the trainin". 3. The initial and annual trainin"% as supplemented !y the pre&production safety meetin"% include all of the re(uired elements% includin" the specific information re(uired a!out the employer-s control measures and the employer-s procedures for exposure incidents and post&exposure evaluation and follow&up. (") ;ecord eepin". (1) 6edical ;ecords. (A) The employer shall esta!lish and maintain an accurate record for each employee with occupational exposure% in accordance with Section 3'D,. These records may !e maintained with an off&site 4<8+4% so lon" as the medical records are immediately availa!le at all times when post&exposure evaluation may !e necessary. ()) This record shall include0 1. The name and any employee identifyin" num!er% if one is used !y the employerH '. A copy of the employeeAs 8)9% 8A9 and 849 vaccination status includin" the dates of all vaccinations and post vaccination testin"% and any medical

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STANDARDS PRESENTATION Attachment No. 1 TO Page 1( of 21 CALIFORNIA OCCUPATIONAL SAFETY AND HEALTH STANDARDS BOARD PROPOSED STATE STANDARD, TITLE 8, DIVISION 1, CHAPTER 4 records relative to the employeeAs a!ility to receive vaccination as re(uired !y su!section (e)(')H 3. A copy of all results of examinations% medical testin"% and follow&up procedures as re(uired !y su!section (e)(1) and (e)(3)H ,. The employerAs copy of the healthcare professionalAs written opinion as re(uired !y su!section (e)(5) and (e)(G)H and 5. A copy of the information provided to the healthcare professional as re(uired !y su!sections (e)(,) and (e)(>). 4C6 +onfidentiality. The employer shall ensure that employee medical records re(uired !y su!section (")(1) are0 1. Kept confidentialH and '. Cot disclosed or reported without the employeeAs express written consent to any person within or outside the wor place except as re(uired !y this section or as may !e re(uired !y law. (.) The employer shall maintain the records re(uired !y su!section (")(1) for at least the duration of employment plus 3D years in accordance with Section 3'D,% Access to ?mployee ?xposure and 6edical ;ecords. (') Trainin" ;ecords. (A) Trainin" records shall include the followin" information0 1. The dates of the trainin" sessionsH '. The contents or a summary of the trainin" sessionsH 3. The names and (ualifications of persons conductin" the trainin"H and ,. The names and *o! titles of all persons attendin" the trainin" sessions. ()) Trainin" records shall !e maintained for 3 years from the date on which the trainin" occurred. (3) ;ecords of implementation of the ?xposure +ontrol 4lan. (A) ;ecords of annual review of the ?xposure +ontrol 4lan shall include the name(s) of the person conductin" the review% the dates the review was conducted and completed% the name(s) and *o! cate"ories of employees involved% and a summary of the conclusions. The record shall !e retained for three years. ()) ;ecords of the evaluation of exposure incidents shall !e retained and made availa!le as employee exposure records in accordance with Section 3'D,. These records shall include0 1. The date of the exposure incidentH '. The names% and any other employee identifiers used in the wor place% of employees and other persons who were included in the exposure evaluationH 3. The type of wor activity !ein" performed and the employer-s control measures for that activity.

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STANDARDS PRESENTATION Attachment No. 1 TO Page 18 of 21 CALIFORNIA OCCUPATIONAL SAFETY AND HEALTH STANDARDS BOARD PROPOSED STATE STANDARD, TITLE 8, DIVISION 1, CHAPTER 4 ,. A summary of how the exposure incident occurred% and whether exposure resulted from a lac of use of specified control measures% a failure of control measures% or other factors. ,. A statement as to whether the exposure was reported and appropriate medical follow&up was provided in a timely manner. 5. The date of the evaluation. G. A description of any corrective action ta en% and the date of that action. . (,) Each producer shall create and maintain a log of information for all scenes or other representations produced or purchased. The log shall contain the information listed in subsections (g)(4)(A) through (G)(4)(E) below. The records re(uired !y this su!section shall !e maintained for a minimum of 5 years. (A) The date the activities involvin" occupational exposure were performed. ()) The street address% city and state where the production occurred. (+) The sta"e name% le"al name% residence address% and phone num!er for each person who participated in the production% includin" production crew% actors% and directors. (.) The name% address% and phone num!er of the entity responsi!le for the production% and the name% address and phone num!er of any employer or other producer to which the video% film% or other representation was sold. (?) A record of the en"ineerin" and wor practice controls and personal protective e(uipment used durin" the production. ?xception to su!section (")(,)H An employer who solely reproduces and distri!utes material o!tained from another producer in its entirety% and who does not further edit or com!ine the material% need only record and maintain the information re(uired in su!section (")(,)(.). (5) Availa!ility. (A) The employer shall ensure that all records% other than the employee medical records more specifically dealt with in su!section (")(5)(+)% re(uired to !e maintained !y this section shall !e made availa!le upon re(uest to the +hief% C53S8% the +alifornia .epartment of 4u!lic 8ealth% and the local health officer for examination and copyin". ()) ?mployee trainin" records% the exposure control plan% and records of implementation of the exposure control plan% other than medical records containin" individually identifia!le medical information% shall !e made

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STANDARDS PRESENTATION Attachment No. 1 TO Page 1. of 21 CALIFORNIA OCCUPATIONAL SAFETY AND HEALTH STANDARDS BOARD PROPOSED STATE STANDARD, TITLE 8, DIVISION 1, CHAPTER 4 availa!le as employee exposure records in accordance with section 3'D,(e) (1) to employees and employee representatives. (+) ?mployee medical records re(uired !y this su!section shall !e provided upon re(uest to the su!*ect employee% anyone havin" the written consent of the su!*ect employee% the +alifornia .epartment of 4u!lic 8ealth% the local health officer% the +hief% and C53S8 in accordance with section 3'D, of these orders% Access to ?mployee ?xposure and 6edical ;ecords% for examination and copyin". (G) Transfer of ;ecords. (A) The employer shall comply with the re(uirements involvin" the transfer of employee medical and exposure records that are set forth in section 3'D,% Access to ?mployee ?xposure and 6edical ;ecords% of these orders. ()) 5f the employer ceases to do !usiness and there is no successor employer to receive and retain the records for the prescri!ed period% the employer shall notify the +hief and C53S8% at least three months prior to the disposal of the records and shall transmit them to C53S8% if re(uired !y C53S8 to do so% within that three&month period. (h) Appendices A1% A'% A3% and ) to this section are incorporated as a part of this section and the provisions are mandatory. Appendix A1&8epatitis ) 9accine .eclination (6AC.AT3;L) The employer shall assure that employees who decline to accept hepatitis ) vaccination offered !y the employer si"n the followin" statement as re(uired !y su!section (e)('(/)0 5 understand that due to my occupational exposure to !lood or other potentially infectious material F sexually transmitted 5nfections (3456&ST5)% 5 may !e at ris of ac(uirin" hepatitis ) virus (8)9) infection. 5 have !een "iven the opportunity to !e vaccinated with hepatitis ) vaccine% at no char"e to myself. 8owever% 5 decline hepatitis ) vaccination at this time. 5 understand that !y declinin" this vaccine% 5 continue to !e at ris of ac(uirin" hepatitis )% a serious disease. 5f in the future 5 continue to have occupational exposure to !lood or 3456&ST5 and 5 want to !e vaccinated with hepatitis ) vaccine% 5 can receive the vaccination series at no char"e to me. Appendix A'&8uman 4apilloma 9irus 9accine .eclination (6AC.AT3;L) The employer shall assure that employees who decline to accept human

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STANDARDS PRESENTATION Attachment No. 1 TO Page 2- of 21 CALIFORNIA OCCUPATIONAL SAFETY AND HEALTH STANDARDS BOARD PROPOSED STATE STANDARD, TITLE 8, DIVISION 1, CHAPTER 4 papilloma vaccination offered !y the employer si"n the followin" statement as re(uired !y su!section (e)(')(/)0 5 understand that due to my occupational exposure to other potentially infectious material F sexually transmitted infections (3456&&ST5)% 5 may !e at ris of ac(uirin" human papilloma virus infection. 5 have !een "iven the opportunity to !e vaccinated with human papilloma vaccine% at no char"e to myself. 8owever% 5 decline human papilloma vaccination at this time. 5 understand that !y declinin" this vaccine% 5 continue to !e at ris of ac(uirin" human papilloma virus% an incura!le infection that may !e transmitted to others% and may increase the ris that 5 may develop cancer. 5f in the future 5 continue to have occupational exposure to !lood or 3456&ST5 and 5 want to !e vaccinated with human papilloma vaccine% 5 can receive the vaccination series at no char"e to me. Appendix A3&8epatitis A 9accine .eclination (6AC.AT3;L) The employer shall assure that employees who decline to accept hepatitis A vaccination offered !y the employer si"n the followin" statement as re(uired !y su!section (e)(')(/)0 5 understand that due to my occupational exposure to other potentially infectious material F sexually transmitted infections (3456&&ST5)% 5 may !e at ris of ac(uirin" hepatitis A virus infection. 5 have !een "iven the opportunity to !e vaccinated with hepatitis A vaccine% at no char"e to myself. 8owever% 5 decline hepatitis A vaccination at this time. 5 understand that !y declinin" this vaccine% 5 continue to !e at ris of ac(uirin" hepatitis A virus% an infection that may !e transmitted to others% and may cause serious disease. 5f in the future 5 continue to have occupational exposure to !lood or 3456&ST5 and 5 want to !e vaccinated with hepatitis A vaccine% 5 can receive the vaccination series at no char"e to me. Appendix )0 :se of 4rotective )arriers (6andatory) These procedures shall include0 1. 3nly latex% polyurethane% or other /.A&approved condoms will !e used. )arriers will !e made of latex% polyurethane% or other non&permea!le material. '. +ondoms that do not contain nonoxynol&9 and other spermicides shall !e availa!le at all times when wor re(uirin" condoms is performed. 3. +ondoms will not !e used with lu!ricants capa!le of compromisin" the inte"rity of the condom !arrier (e.". latex condoms will not !e used with oil& !ased lu!ricants).

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STANDARDS PRESENTATION Attachment No. 1 TO Page 21 of 21 CALIFORNIA OCCUPATIONAL SAFETY AND HEALTH STANDARDS BOARD PROPOSED STATE STANDARD, TITLE 8, DIVISION 1, CHAPTER 4 ,. +ondoms will !e used with sufficient lu!ricant to minimi@e potential !rea a"e. <u!ricant shall not !e irritatin" to mucous mem!ranes. 5. Co condom will !e used that is past the mar ed expiration date. +ondoms (internal or external) will !e used accordin" to the manufacturer-s instructions and /.A approval. G. Co condom or other !arrier will !e reused. >. )arriers will !e used so that only one side has contact with a performer-s "enitalia% anus% or 3456EST5. =. Co condom will !e used if the interior of the condom has contact with another performer-s !lood# 3456EST5 prior to !ein" put in place for use. 9. The same condoms or other !arriers will not !e used for different anatomical sites or different performers. 1D. +ondoms and other !arriers will !e put in place prior to any contact with !lood or 3456EST5. A&tho%!t, c!te+ Sect!on 142.1, La'o% Co+e. Refe%ence Sect!on 142.1, La'o% Co+e.

NOTE

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