An OSHA Q&A on MRSA infections in the workplace

By: July 23rd, 2009 Email This Post Print This Post

Working in a healthcare facility of any size means exposure to highly contagious MDROs such as MRSA is an everyday occurrence.  By wearing the correct personal protective equipment (PPE) and following standard precautions, workers can protect themselves from these infections, but what if an employee claims their MRSA infection was contracted at work?

The following questions were submitted through email to an OSHA spokesperson for clarification on how to determine if a MRSA infection is workplace related.

Q: What is the procedure per OSHA standards when a worker is exposed to MRSA from a patient?

A: As with any workplace hazard, employers are required to perform a hazard assessment and implement feasible measures for protecting employees (e.g engineering and administrative controls, as well as personal protective equipment, such as gloves, gowns and face masks.) An employer must make the determination as to what measures best protect the worker based on the tasks being performed. Please refer to the MRSA section of OSHA’s Hospital eTool for a comprehensive set of information and guidance on workplace exposures to MRSA.

Q: What standard does a workplace MRSA infection fall under?

A: Compliance with several OSHA Standards will assist with improving the protection of employees who may be exposed to MRSA in the workplace. Please see [the OSHA site] for a Q&A which provides a list of OSHA standards of special importance.

Q: Is there a procedure to determine if a MRSA infection was in fact an occupational exposure?

A: Employers would need to use similar methods of evaluating exposures to other infectious diseases to which employees may be exposed. The CDC offers guidance on transmission prevention and exposure evaluation and management in their 2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings. With regard to OSHA investigations, this determination would be made on a case-by-case basis.

Q: If an employer enforces standard precautions, and provides proper training and PPE, but the employee fails to comply with protocols and ends up with a MRSA infection, is there any culpability on the employer’s part? Can they be cited even though they have taken the proper steps to protect employees?

A: That’s part of the case-by-case evaluation mentioned previously. OSHA investigators look at factors such as whether the employer was aware that the employee was not compliant with the precautions set by the facility, but still allowed employees to break the rules, or whether the employer had disciplined employees in the past for not complying. The final determination is based on the particular circumstances in each situation.

Q: Is there an obligation to pay for testing for employees potentially infected with MRSA?

A: As you know, there is no specific OSHA standard addressing this issue. However, healthcare settings would be considered responsible for the payment of tests determined to be necessary in the evaluation of an employee who has had an unprotected exposure.

Q: Should infections be recorded in the OSHA 300 log, injury an illness log?

A: Employers are required to record exposures on the 300 log if the exposure meets one or more of the criteria outlined in 29 CFR 1904.7 through 1904.11 (OSHA’s recordkeeping standard). For example, recordkeeping is required under the following circumstances: a MRSA exposure which leads to a) employees becoming infected as a result of a workplace exposure; b) medical treatment is provided to the exposed employee; or c) employees miss at least one full day of work.

Comments

By Julia PIlas on July 29th, 2009 at 10:34 pm

I find it bewildering that this articles sole concern is focused only on the workers of a healthcare facilities well being…what about the poor defenseless patients who are healthy enough to walk into a hospital but are mutilated so horrifically from MRSA that they contracted during their hospital stay and are carried out in a body bag. Why does MRSA continue to be this countries “best kept secret” and why do hospitals continue to expect and accept what these infections are doing. When is someone going to do their job and do something about these infections. This is the United States of America in the 21st century not a third world country in the stoneage. How dare anyone think these infections and how they are destroying families and loved ones should be accepted. Read my book and see what MRSA has done to my family http://www.juliapilasauthor.com.

By David LaHoda on July 30th, 2009 at 12:27 am

Thanks for your comments, Julia, and for raising issues about the patient side of MRSA. I must point out that this article is from a publication dealing with occupational health and safety issues, as is this blog site. I find that most of the MRSA literature is already related to patent safety, which I why I believe the hazards to workers needed to be addressed.

A subject not covered here is the right to know about a hazard in the workplace. I was assigned to provide direct care toileting an individual who has had reoccurent MRSA infections in his urine. My employer would have been aware of this as he had a pic line put in 3 days after being returned to work after being hospitolized for a uti, and subsequently was going to the hospital BID, for 6 wks. I can deduce from this that he was getting vancomycin. About a month later i found what i thought was a zit in my armpit, that never came to a head. By two months i had already developed a systemic infection that included (multiple) grape sized abscesses forming in both armpits as well as a respiratory infection. Another 2 months later (and on antibiotic #3, and steroid #2) my physician has told me i have mrsa.
Had i been told to use universal body substance contact precautions, i would most likely not been infected. Had i been told the individual had an ctive infection i ould have sanitized the toilet after the infected individual used it and prior to anyone else.
I would be fired if i divulged to the guardians of the people in the day program (adults with MR) that thier child (or brother or sister) that they may have been exposed due to a failour of my employer to comply with the policies and procedures mandated by our licencing entity and as near as i can tell OSHA as well.

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