OSHA Bloodborne Pathogens Standard: the employer duties the CCMA tests

29 CFR 1910.1030 is the one rule on this exam whose citation you can be quizzed on directly, and its questions are about employer duties rather than clinical judgment. Three of them carry most of the points: how often the exposure control plan has to be reviewed, what actually happens when a new hire declines the hepatitis B vaccine, and which body fluids the standard covers at all. Candidates who answer from general infection-control instinct rather than from the text of the standard lose all three.

The rule itself	29 CFR 1910.1030, an enforceable OSHA regulation. CDC publishes recommendations; OSHA writes law, so a question phrased as what an employer "must" do points here
Exposure control plan	Written, accessible to employees, and reviewed and updated at least annually AND whenever new or modified tasks, procedures or positions affect occupational exposure — 1910.1030(c)(1)(iv)
What the annual review must document	Consideration and implementation of safer engineered sharps devices, with input solicited from non-managerial employees who actually use them — 1910.1030(c)(1)(iv)(B) and (c)(1)(v)
Hepatitis B vaccine	Offered after training and within 10 working days of initial assignment, at no cost to the employee — 1910.1030(f)(2)(i)
Declination	The employee signs the Appendix A declination form, whose wording OSHA prescribes, and keeps the right to accept the vaccine free of charge at any later date. Declining is not permanent and cannot bar her from her duties
Post-vaccination check (CDC)	Anti-HBs drawn 1 to 2 months after the final dose; 10 mIU/mL or greater means immune
OPIM — what is covered	Semen, vaginal secretions, cerebrospinal, synovial, pleural, pericardial, peritoneal and amniotic fluid, saliva in dental procedures, and any fluid visibly contaminated with blood
OPIM — what is not	Feces, urine, vomit, sweat, tears, nasal secretions and sputum are NOT covered unless visibly bloody. This is the most-missed line in the standard
Training	At the time of initial assignment and at least annually thereafter — 1910.1030(g)(2)(ii)
Recordkeeping	Employee medical records: duration of employment plus 30 years (29 CFR 1910.1020). Training records: 3 years. Sharps injury log: required once the employer has more than 10 employees — 1910.1030(h)
Cost to the employee	Zero. Vaccine, PPE, post-exposure evaluation, source and employee testing, and follow-up are all employer-paid

Where the point is lost: OSHA still writes "universal precautions" in 1910.1030(d)(1), so a question can use that phrase and still be current; the agency accepts CDC's standard precautions as an equivalent or more protective approach. The distinction worth memorizing is scope. Universal precautions treat blood and the listed OPIM as infectious. Standard precautions go further and cover all body fluids, secretions and excretions except sweat, whether or not blood is visible, plus non-intact skin and mucous membranes. That is exactly why urine, stool and sputum sit outside the bloodborne standard but still get gloves at the bedside.