- 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 http://www.osha.gov.
April 23, 2007
Mr. Scott Weisman
2511 Montclaire Circle
Weston, FL 33327
Dear Mr. Weisman:
Thank you for your letter to the Occupational Safety and Health Administration's (OSHA's) Directorate of Enforcement Programs (DEP) regarding coverage of employees under OSHA's Bloodborne Pathogens standard [29 CFR 1910.1030]. Your questions are paraphrased below, followed by OSHA's responses. This letter constitutes OSHA's interpretation only of the requirements discussed and may not be applicable to any question(s) not delineated within your original correspondence.
Question 1: It is my understanding that in order for a personal trainer to get certified to use the Automated External Defibrillator (AED), he/she must take a CPR course. Once the certified user responds to an emergency, he/she may need to perform CPR and be at risk of exposure to blood or other potentially infectious materials. With this in mind, is it reasonable to assume that 1910.1030 becomes applicable, and these employees must receive bloodborne pathogens training?
Reply 1: You are correct in stating that a first aid responder who is certified to use an AED could be at risk for exposure to blood or other potentially infectious materials (OPIM) during an emergency response. It is recognized by the American Heart Association (AHA) that those who are responsible for operating AEDs must also receive CPR training as an "integral part of providing life saving aid to people suffering sudden cardiac arrest." According to the AHA, many States now require or encourage AED users to complete basic CPR and AED courses from a nationally-recognized organization (http://www.cpr-ecc.org). You are also correct that the State of Florida requires that "all persons who use an automated external defibrillator must obtain appropriate training, to include completion of a course in cardiopulmonary resuscitation [CPR] or successful completion of a basic first aid course that includes cardiopulmonary resuscitation" (Fla. State chi. 401.2915(2)(a)).
However, the mere fact that a person has received training on AED operation does not automatically evoke coverage under the bloodborne pathogens standard. It is the likelihood that a trained first aid provider could have "occupational exposure" that determines the standard's applicability. The Bloodborne Pathogens standard defines "occupational exposure" as "reasonably anticipated skin eye, mucous membrane, or parenteral contact with blood or other potentially infectious materials that may result from the performance of an employee's duties" (§1910.1030(b)).
Persons who perform first aid and CPR are reasonably anticipated to have exposure to blood and OIPM. However, the Bloodborne Pathogens standard applies only if that exposure "may result from the performance of an employee's duties." Thus, for example, if an employee is trained in first aid (including CPR and AED training) and is identified by the employer as responsible for rendering medical assistance as part of his/her job duties, there is an anticipated occupational exposure, and the Bloodborne Pathogens standard applies (CPL 02-02-069, XIII(A)(3)(c)). This includes employees designated as first aid providers who render assistance at a workplace first aid station, clinic or other workplace location where injured employees go routinely for assistance (CPL 02-02-069, XIII(F)(8)(b)). It also includes employees who are expected to render first aid as a collateral duty to their routine work assignments. In addition, employees who routinely provide first aid and CPR while at work, with the knowledge of the employer, also may fall, de facto, under the occupational exposure designation even if the employer had not officially designated the employees as first aid providers (CPL 02-02-069, XIII(F)(8)(b)).
Question 2: Some states across the country are now requiring gyms [fitness centers] to have an AED, which requires a certification in CPR. Additionally, [personal] trainers at the gyms need to be certified in CPR to keep their state training licenses. Once a CPR-certified trainer responds to an emergency, he/she may need to perform CPR and be at risk of exposure. If a person is not required to respond and they've only taken the class to get their license, is the bloodborne pathogens standard applicable?
Reply 2: You mention that some States require gyms to have AEDs and trainers at gyms to be certified in CPR in order to retain their State license. Once again, those requirements, in themselves, do not trigger application of the Bloodborne Pathogens standard. The analysis is the same as our response to your first question. If trainers at gyms are not required or expected as part of their job duties to perform CPR, there is no occupational exposure, and the standard does not apply. However, as we pointed out above, if trainers, with the knowledge of the employer, routinely provide CPR at the workplace, then the standard may apply even if the employer has not officially included CPR in the employee's job duties.
Question 3: Physical therapists and personal trainers are required to be certified in CPR in order to get their license from the state. Since this is a requirement for a license, is it then an expectation that they would be required to respond to an emergency as part of their job description?
Reply 3: In general, a State licensing requirement to be CPR-certified does not create an expectation that responding to emergencies and providing CPR is part of a physical therapist's or personal trainer's job description. For example, physical therapists working in hospitals or other facilities may not be part of the facility's emergency response or AED team. In such cases, there is no expectation that the therapist's job duties include performing CPR or using AEDs because that duty may be assigned to other employees within the workplace.
Thank you for your interest in occupational safety and health. We hope you find this information helpful. 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. 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 http://www.osha.gov. If you have any further questions, please feel free to contact the Office of General Health Enforcement at (202) 693-2190.
Richard E. Fairfax, Director
Directorate of Enforcement Programs