Fillable Exposure To Health Risks Physical Demands Form (Page 3 of 7) in pdf

EXPOSURE TO HEALTH RISK/PHYSICAL DEMANDS INFORMATION

Description of Programs and Requirements

MSU employees working in specific environments and/or performing duties as listed below must comply

with medical monitoring and training program requirements as mandated by Federal and State laws,

regulations, statues, or best practices. The following list provides examples of the types of duties and/or

exposures that place employees under Federal and State guidelines for medical surveillance or specific

training. It is the responsibility of the supervisor to review their requirements and initiate required

procedures at the time of hire, transfer or change in job duties as outlined below. If any of the items 1-11

are applicable risks, please complete an Exposure to Health Risk/Physical Demands Form and follow the

requirements described for appropriate risk.

Exposure to human blood, serum, tissue and other body fluids and materials covered under

“Universal Precautions.”

This covers employees at MSU that have a reasonable anticipated risk of exposure to human blood

and other potentially infectious materials. This includes Hepatitis B Virus (HBV), Human

Immunodeficiency Virus (HIV), and other bloodborne pathogens that are included in MSU’s

Bloodborne Pathogen Program as outlined in the Exposure Control Plan (ECP).

Job classifications, in which all or some of the employees have potential occupational exposure to

bloodborne pathogens, are listed in Appendix A of the ECP. The ECP is revised on an annual basis

and copies of the most recent edition are available on the Environmental Health and Safety (EHS)

website at

The MSU Exposure Control Plan requires all employees to attend an

initial training as well as an annual retraining on bloodborne pathogens. Employees covered under

this program must be offered free Hepatitis B vaccination within the first ten days of employment.

For more information, call EHS at 355-0153.

Required monitoring/training:

●Biological Safety Training link- , then click on

training link.

●Completion of Hepatitis B surveillance sheet (only one time) received during bloodborne

pathogens training. Form must be completed, sent to MSU Occupational Health, and appropriate

follow up arranged within 10 days of assignment to duties involving potential exposure to

bloodborne pathogens.

TB risk or work within 3 feet of human patients in a health care setting or have potential

exposure to animals or to specimens with Mycobacterium.

This program is designed to determine the risk of occupational exposure to Tuberculosis (TB)

and/or measles, mumps, rubella, chicken pox, and pertussis.

Those with potential occupational exposure to TB must have baseline TB monitoring within first 10

days of employment or start of risk. Follow up monitoring is determined based on risk. This would

apply to employees that interact closely (within 3 feet) with patients or animals suspected or

confirmed with TB. This includes both human and veterinary healthcare workers. Additionally,

human healthcare workers have potential risk for exposure to and/or measles, mumps, rubella,

chicken pox, and pertussis. This may include, but is not limited to, physicians, nurses, aides, dental

workers, technicians, some workers in laboratories and morgues, emergency medical service (EMS)

personnel, student employees, part-time personnel, temporary staff not employed by the health

care facility, and persons not involved directly in patient care but who are potentially at risk for

exposure to Tuberculosis (e.g., research setting, maintenance).

Veterinary healthcare workers that have exposure potential to Mycobacterium are included in the

baseline skin testing program. This would include, but is not limited to, animal diagnostic facility

Exposure To Health Risks Physical Demands Form Page 3

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