The revision to the Occupational Safety and Health Administration's (OSHA) blood borne pathogens standard added new requirements for employers, including additions to the exposure control plan and keeping a sharps injury log. It does not impose new requirements for employers to protect workers from sharps injuries; the original standard already required employers to adopt engineering and work practice controls that would eliminate or minimize employee exposure from hazards associated with blood borne pathogens.
The revision does, however, specify in greater detail the engineering controls, such as safer medical devices, which must be used to reduce or eliminate worker exposure.
Exposure Control Plan
The revision includes new requirements regarding the employer's Exposure Control Plan, including an annual review and update to reflect changes in technology that eliminate or reduce exposure to blood borne pathogens. The employer must:
- take into account innovations in medical procedure and technological developments that reduce the risk of exposure (e.g., newly available medical devices designed to reduce needlesticks)and
- document consideration and use of appropriate, commercially-available, and effective safer devices (e.g., describe the devices identified as candidates for use, the method(s) used to evaluate those devices, and justification for the eventual selection).
No one medical device is considered appropriate or effective for all circumstances. Employers must select devices that, based on reasonable judgment:
- will not jeopardize patient or employee safety or be medically inadvisable; and
- will make an exposure incident involving a contaminated sharp less likely to occur.
Employee Input
Employers must solicit input from non-managerial employees responsible for direct patient care regarding the identification, evaluation, and selection of effective engineering controls, including safer medical devices. Employees selected should represent the range of exposure situations encountered in the workplace, such as those in geriatric, pediatric, or nuclear medicine, and others involved in direct care of patients.
OSHA will check for compliance with this provision during inspections by questioning a representative number of employees to determine if and how their input was requested.
Documentation of Employee Input
Employers are required to document, in the Exposure Control Plan, how they received input from employees. This obligation can be met by:
- Listing the employees involved and describing the process by which input was requested; or
- Presenting other documentation, including references to the minutes of meetings, copies of documents used to request employee participation, or records of responses received from employees.
Record Keeping
Employers who have employees who are occupationally exposed to blood or other potentially infectious materials, and who are required to maintain a log of occupational injuries and illnesses under existing record keeping rules, must also maintain a sharps injury log. That log will be maintained in a manner that protects the privacy of employees. At a minimum, the log will contain the following:
- the type and brand of device involved in the incident
- location of the incident (e.g., department or work area)
- description of the incident
The sharps injury log may include additional information as long as an employee's privacy is protected. The format of the log can be determined by the employer.
