- Standard Number:
OSHA requirements are set by statute, standards and regulations. Our interpretation letters explain these requirements and how they apply to particular circumstances, but they cannot create additional employer obligations. This letter constitutes OSHA's interpretation of the requirements discussed. Note that our enforcement guidance may be affected by changes to OSHA rules. Also, from time to time we update our guidance in response to new information. To keep apprised of such developments, you can consult OSHA's website at https://www.osha.gov.
October 4, 2000
Katherine West, BSN, MSEd, CIC
Infection Control Consultant
Infection Control/Emerging Concepts, Inc.
7715 Knightshayes Drive
Manassas, VA 20111
Dear Ms. West:
Thank you for your June 28 letter to the Occupational Safety and Health Administration's (OSHA's) Directorate of Compliance Programs. You had specific questions regarding an employer's responsibility for cleaning contaminated medical equipment, as mandated by the Bloodborne Pathogens Standard, 29 CFR 1910.1030. Your question is outlined below, followed by OSHA's response.
According to the scenario illustrated in your letter, a fire or rescue service ("first responder") responds to emergency situations using their equipment to transport and treat patients while en route to a healthcare facility. The hospital or other healthcare facility then removes the patient from the used, contaminated equipment provided by the first responders and proceeds to use its own equipment and medical devices. The facility leaves the equipment used and contaminated for the first responders to pick up and clean.
Your question is: "who is responsible for cleaning this equipment?"
Simply, it is every employer's responsibility to ensure a safe and healthful workplace for its employees. More specifically, according to the Bloodborne Pathogens Standard, each employer with employees who may have an occupational exposure to blood or other potentially infectious materials (OPIM) is responsible for eliminating or reducing the potential hazard. In this case, where equipment is shared between first responders and emergency department or general hospital staff, each employer has responsibilities for protecting employees from exposure to blood or body fluids.
The equipment to which you are referring belongs to the first responders or emergency medical service (EMS) personnel and is to be returned to them for reuse. If a hospital places such equipment, contaminated, in the hallways or in closets awaiting pickup, it is exposing its employees and anyone in the area to potential bloodborne pathogens.
According to paragraph (d)(4)(i) of the standard, "(e)mployers shall ensure that (the) worksite is maintained in a clean and sanitary condition." Paragraph (d)(4)(ii) provides that "all equipment and environmental and working surfaces shall be cleaned and decontaminated after contact with blood or other potentially infectious materials [emphasis added]." Additionally, "(c)ontaminated work surfaces shall be decontaminated with an appropriate disinfectant after completion of procedures; immediately or as soon as feasible when surfaces are overtly contaminated or after any spill of blood or other potentially infectious materials; and at the end of the work shift if the surface may have become contaminated since the last cleaning."
OSHA would regard a hospital as having met its obligations with respect to its own employees either by cleaning and decontaminating the equipment in accordance with (d)(4)(i) of the standard, or, alternatively, by preventing employee contact with such equipment by placing it in durable, leakproof, and labeled or color-coded containers and handling it in a manner similar to that prescribed for contaminated laundry [paragraph 1910.1030(d)(4)(iv)] and contaminated laboratory equipment [paragraph 1910.1030(e)(2)(ii)(B)]. The first responders' employer must then ensure that its employees take proper precautions when retrieving and decontaminating the equipment. The Centers for Disease Control and Prevention (CDC) indicate, in their Infection Control Practices, that communication between two parties with regard to handling and decontamination of supplies and materials is of the utmost importance.
You should be aware that Virginia operates its own Occupational Safety and Health program which must be "at least as effective as" the federal program. Further inquiries regarding this or any other workplace health and safety matter should be addressed to your state office for assistance.
Virginia Department of Labor and Industry
13 South 13th Street
Richmond, VA 23219
Phone (804) 786-2377
Fax (804) 371-6524
Thank you for your interest in occupational safety and health. We hope you find this information helpful. Compliance guidance provided by OSHA represents OSHA's explanation, clarification, or application of the provisions of the OSH Act, OSHA standards or OSHA regulations, but it does not add to, alter, or replace those provisions, which alone are legally binding. You should also be aware that OSHA's compliance guidance is subject to periodic review and clarification, amplification, or correction and can also be affected by subsequent rulemaking or other changes in the law. One way for you to track future changes that might affect the information provided herein is by consulting OSHA's website at http://www.osha.gov. If you have any further questions, please feel free to contact the [Office of Health Enforcement] at (202) 693-2190.
Richard E. Fairfax, Director
[Directorate of Enforcement Programs]