August 1, 1994

Mr. Charles H. Williams
Director, Codes and Standards
National Electrical Contractors Association
Suite 1100
3 Bethesda Metro Center
Bethesda, Maryland 20814

Dear Mr. Williams:

This is in response to your letter of July 7, addressed to Secretary of Labor, Robert Reich, in which you requested a review of the publication "Safety News" as it relates to the Occupational Safety and Health Administration (OSHA) regulation 29 CFR 1910.1030, Occupational Exposure to Bloodborne Pathogens".

The bloodborne pathogens standard is designed to protect the nation's workers, particularly health care workers, from exposure to the hepatitis B virus (HBV), the human immunodeficiency virus (HIV), and other bloodborne pathogens. Of the diseases caused by these viruses, hepatitis B is the most common, with 8,700 cases per year among workers in the health care profession. Hepatitis B infection may result in serious illness, potential long term disability and death. HIV causes AIDS, for which there currently is no cure and which eventually results in death. These viruses, as well as other organisms that cause bloodborne diseases, are found in human blood and certain other human body fluids. Therefore, employers have a particular responsibility to ensure that workers do not come into direct contact with blood or other potentially infectious materials while performing their job.

It is important to note that the definition of "occupational exposure" comprises the reasonable anticipation that the employee will come into contact with these fluids during the course of performing his or her work duties. Therefore, OSHA anticipates that this standard will impact upon all non-health care industries in a similar fashion, i.e., that employees who are designated as responsible for rendering first aid or medical assistance as part of their job duties are to be covered by this standard. This is because it is reasonable to anticipate that an employee designated to render first aid will have occupational exposure to blood or other potentially infectious materials.

You referenced conditions under which exposure could occur including, amongst others, "during contact with trash containing contaminated bandaids, uniforms and feminine hygiene products." 29 CFR 1910.1030 defines regulated waste as liquid or semi-liquid blood or other potentially infectious material (OPIM); items contaminated with blood or OPIM and which would release these substances in a liquid or semi-liquid state if compressed; items that are caked with dried blood or OPIM are capable of releasing these materials during handling; contaminated sharps; and pathological and microbiological wastes containing blood or OPIM.

Bandages which are not saturated to the point of releasing blood or OPIM if compressed would not be considered as regulated waste. Similarly, OSHA does not generally consider discarded feminine hygiene products, used to absorb menstrual flow, to fall within the definition of regulated waste. The intended function of products such as sanitary napkins is to absorb and contain blood; the absorbent material of which they are composed would, under most circumstances, prevent the release of liquid or semi-liquid blood or the flaking off of dried blood.

OSHA expects these products to be discarded into waste containers which are lined in such a way as to prevent contact with the contents. Please note, however, that it is the employer's responsibility to determine which job classifications or specific tasks and procedures involve occupational exposure. For example, the employer must determine whether employees can come into contact with blood during the normal handling of such products from initial pick-up through disposal in the outgoing trash. If OSHA determines, on a case-by-case basis, that sufficient evidence exists of reasonably anticipated exposure, the employer will be held responsible for providing the protections of 29 CFR 1910.1030 to the employees with occupational exposure.

The reference that is made in the publication statement regarding voluntary acts is keeping with OSHA's view. It is correct that employees who perform "Good Samaritan" acts are not, per se, covered by this standard, although OSHA would encourage an employer to offer follow-up procedures to an employee who experiences an exposure incident as the result of performing a "Good Samaritan" act. This is because such an act does not constitute "occupational exposure", as defined by the standard.

The key to this issue is not whether employees have been trained in first aid, but whether they are also designated as responsible for rendering medical assistance. For instance, while all line workers may be trained in first aid and CPR, not all of these employees would necessarily be designated to render first aid. For example, a six-person crew could have two of the six employees designated to render medical assistance and also to be covered by the protections of 29 CFR 1910.1030. The standard does not necessarily apply to employees who are trained in first aid (especially when the company only requires that employees perform forms of emergency assistance that do not involve exposure to body fluids) but rather to those employees who are required by the employer to actually administer first aid.

However, there is a situation referred to as "de facto" designation which needs to be recognized by the employer. If an employee is expected, as part of his or her job duties, to render first aid or medical assistance, that employee is covered by the requirements of the standard. Such an expectation would constitute a de facto designation of the employee and OSHA, additionally, would require the employer to comply with the elements of the standard.

Please note that OSHA has issued a policy statement specifying that failure to offer the hepatitis B vaccine pre-exposure to persons who render first aid only as a collateral duty, will be considered a de minimis, or technical, violation carrying no penalties, provided that a number of conditions are met. These are described in OSHA Instruction CPL 2-2.44C, "Enforcement Procedures for the Occupational Exposure to Bloodborne Pathogens Standard". Please refer to the enclosed pages of the Bloodborne Pathogens Interpretative Quips. All other requirements of the standard continue to apply to designated first aid providers.

OSHA's policy is not to approve of products, programs, or other literature from companies and associations. We conducted a general review of your publication to assess its overall compliance with the bloodborne pathogens standard. Your interest in safety and health is appreciated and in reading your publication the issues that did come to our attention were addressed above. I hope this information is responsive to your concerns.

Sincerely,



John B. Miles, Jr. Director
Directorate of Compliance Programs