Top-ten list of OSHA interpretation letters

By: April 22nd, 2009 Email This Post Print This Post

Another David whose last name also begins with an “L” has made a pretty good living with top-ten lists. So I’m giving you my top-ten list of OSHA interpretation letters to help resolve disputes about compliance with the bloodborne pathogens standard.

I find interpretation letters helpful in answering OSHA questions because they usually get at specific situations, whereas the standard is written too broadly to answer those “show-me-where-OSHA-says” challenges. Keep the letters handy as I found they answer the most frequent questions safety officers will encounter in administering compliance with the standard. There are 306 bloodborne-pathogens-related letters on the OSHA web site the last time I counted.

Cue the drum roll.

Now the countdown of the most useful OSHA letters of interpretation to have in a healthcare facility, with annotations:

10. 2006 – 05/17/2006 – Requirements for covered beverages at nurses’ stations.
You would be surprised at how many people insist upon eating and drinking in the most questionable places.

9. 1995 – 11/02/1995 – Clarification on OSHA’s policy regarding the requirements for hand washing facilities inside an examination room.
Common question, especially when practices are building or refurbishing new facilities.

8. 2007 – 02/07/2007 – Documentation of employees’ hepatitis B vaccination status.
Face it; hepatitis B vaccination documentation is just confusing.

7. 2002 – 11/21/2002 – Safer medical devices must be selected based on employee feedback and device effectiveness, not Group Purchasing Organizations.
Use this when you get push-back from the bean counters about buying outside of purchasing contracts for safety devices.

6. 2007 – 01/08/2007 – Use of rapid HIV antibody testing on a source individual after an exposure incident.
Why wouldn’t you want to give your exposed employee information at the soonest possibility and in time to consider the most options?

5. 2006 – 06/16/2006 – Wearing sandals in a medical office when feet do not contact blood or OPIM.
You have no idea how many healthcare workers believe it is a constitutional right to expose some part of the foot in the workplace.

4. 2000 – 03/10/2000 – HBV antibody testing is required after vaccination series; HBV booster not required.
Believe it or not, I still receive astonished responses concerning how long this rule has been in effect.

3. 2005 – 11/09/2005 – Periodic serologic testing to monitor antibody concentrations after completion of the hepatitis B vaccine three-dose series is not recommended.
This question usually comes up when you have a group of workers who were vaccinated more than 10 years ago.

2. 2005 – 06/03/2005 – Definition of contaminated sharps; engineering controls and good workpractice controls must be implemented; ECP must be reviewed annually.
For those wannabe lawyers who place more importance on discovering a loophole in the bloodborne pathogen standard than in providing a safe workplace for their co-workers.

And the number-one letter to have:

1. 2004 – 01/20/2004 – Bloodborne Pathogens Standard application to small healthcare facilities and the annual review of the Exposure Control Plan.
This is the perfect response when a know-it-all doctor says his practice is too small to be covered by OSHA regulations. Print it out and show it to him or her. Don’t you wish most disputes could be handled in such a tidy way!

Do you find OSHA interpretation letters helpful for your job? Are there other letters which you would like to call to our attention? Let us know in the comment section below.


Comments

By Beth Esser on April 22nd, 2009 at 9:53 am

What are OSHA guidelines when a patient has “stool” in bedlinens, the outside laundry refuses to accept laundry unless the laundry is rinsed of the stool prior to being sent out. I know the guidelines say not to rinse in patient care “area”
thanks

By David LaHoda on April 22nd, 2009 at 10:13 am

OSHA standards are not specific on this matter, but the bottom line is you cannot use OSHA regulations to force the laundry to receive the bed linens as you describe.

As you stated, OSHA bloodborne pathogens (d)(4)(iv)(A)(1) prohibits sorting and rinsing in the patient care area, but not necessarily in other areas of your facility, providing you use PPE.

By Janie Ellison on April 28th, 2009 at 11:00 am

Thank you for the letters they are VERY helpful.

By kimberly mislevy on July 15th, 2009 at 10:21 am

I enjoy these letters and they actually helped in getting saftey scaples for our offices.
Another question,We are in the process of writing a protocol for patients and syriges, We have a large number of patients that after surgery are being pre-filled syringes of Lovenox. at this point the office manager and doctors have stated to have the patients bring the syringes back to the office when done and we will dispose of them in our sharpes containers. this is very unsafe. Is there an OSHA Regulation that covers patients and pre-filled syringes and how to properly dispose of them.

Contact your local county health department. Many have sharps containers available at no charge. If not, they will tell you proper disposal methods for your area.

In a medical setting linen is “presumed” to be contaminated with OPIM and appropriate PPE required. Does the in-house laundry operation of a correctional facility meet the OSHA standard of linen and uniforms being presumed contaminated with OPIM?

By David LaHoda on September 9th, 2009 at 2:48 pm

I’m not sure of your use of the term “presumed” as OSHA always makes it the employer’s responsibility to identify workplace hazards.

First identify if the linen meets the OSHA definition of contaminated laundry:

“Laundry which has been soiled with blood or other potentially infectious materials or may contain sharps.”

Then identify if any of your workers meet the OSHA definition of occupational exposure:

“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.”

As a guide, OSHA”s “Enforcement Procedures for the Occupational Exposure to Bloodborne Pathogens” says that the bloodborne pathogens standard may apply, but not automatically, to “…employees in clinics in industrial, educational, and correctional facilities… and correctional officers…”

If the situation meets the definitions then your in-house laundry and PPE rules must be OSHA compliant.

One final note. Federal bloodborne pathogens compliance may vary for state and municipal workers in a state with its own OSHA agency.

 

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