Some Seek OSHA Health Care Infectious Disease Standard

The agency's May 2010 request for information attracted comments for and against a rulemaking that would address workers' protection against exposure to H1N1, TB, and other diseases.

As often happens with a potential OSHA rulemaking effort, the agency's May 2010 request for information on infectious disease control in health care settings has drawn comments for and against a rulemaking. The PPE provider comments generally urge OSHA to issue a regulation for this area, as California did recently with its standard on infectious diseases transmitted through aerosol and droplet routes, while comments from health care organizations generally say current Joint Commission, CMS, and other standards are already sufficient, so no action by OSHA is warranted.

Robert A. Weber, CIH, laboratory manager for 3M OH&ESD Technical Service and Regulatory Affairs, filed comments Aug. 4 that say 3M has been asked about respirators in the past decade that could protect against TB, hantavirus, coronovirus, anthrax spores, smallpox, Legionella, avian flu, H1N1 flu, and more. Saying CDC's respirator recommendations are not sufficient, apparently because of a lack of understanding about respirators, Weber writes, "OSHA needs to take control of this area and develop criteria for selecting respirators for reducing exposure to infectious agents."

Comments submitted for Peggy Thompson, RN,BSN, CIC Director, Infection Prevention for Tampa General Hospital, take the opposite view. She describes her hospital's extensive infection control program and writes that existing regulations from the Joint Commission and state and local health departments are effective. "Workers in the public transportation areas are at much higher risk for exposure to airborne diseases than healthcare workers due to their work in confined air spaces and lack of personal protective equipment," Thompson writes. "Also, in hospitals we have not only personal protective equipment, but also disinfectant wipes and waterless hand degermer readily available to protect us from exposure to airborne, droplet or contact transmissible organisms. People who work with the public do not have this luxury."

Thompson also says she believes very small businesses would have a hard time complying with an OSHA standard's PPE requirements in the volumes needed to protect their workers.

Barbara Materna, Ph.D., CIH, chief of the California Department of Public Health's Occupational Health Branch, also filed comments describing CDPH's work with Cal/OSHA on its transmissible diseases standard and reporting its own survey of health care workers at 16 acute care hospitals in 2009 indicated workers readily wore and trusted N95 respirators to protect themselves when working with suspected or confirmed H1N1 patients. Some reported problems with N95s, including being uncomfortably warm or have difficulty speaking or being understood because of one, according to her comments.

Dan Shipp, president of the International Safety Equipment Association, submitted comments saying any OSHA rule on infectious diseases "must be as broad as possible," and its default requirement should be that workers are protected from all routes of exposure and wear NIOSH-approved respiratory protection that is fit tested, where applicable, plus other appropriate PPE.

The comments are available in Docket No. OSHA–2010–0003 on www.regulations.gov.

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