Who Needs to Follow the OSHA BBP Standard in the Lab?

For clinical labs that follow the Occupational Safety and Health Administration’s (OSHA’s) Bloodborne Pathogens Standard, who the standard applies to is usually straightforward—staff who handle blood and other bodily fluids. But even staff who don’t usually handle such products could be covered by the standard and should be part of facilities’ exposure control plans, as illustrated by a recent news story.

Though not involving a laboratory, in this case, an employee of US drugstore chain Rite Aid was instructed to clean up human blood after a customer was injured. The employee was not offered a hepatitis B vaccine and the particular Rite Aid store did not have an appropriate exposure control plan in place. As a result, that Rite Aid location was fined over $30,000—which was later negotiated down to $10,000—for not following the OSHA Bloodborne Pathogens Standard.¹

Such exposures are not uncommon. According to NMS Health, a company that conducts occupational health screenings, there are three million exposures to bloodborne pathogens (BBP) for US workers per year.² That’s a lot of exposure to potentially dangerous pathogens. Here’s what lab leaders should know about which staff members to include when developing their exposure control plans to ensure OSHA compliance:

Who is covered by the standard?

The standard applies to all employees who have occupational exposure to blood or other potentially infectious materials (OPIM). Key definitions in the standard include:³

• Occupational exposure is defined 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.
• Blood is defined as human blood, human blood components, and products made from human blood.
• Other potentially infectious materials are defined as the following: saliva in dental procedures; semen; vaginal secretions; cerebrospinal, synovial, pleural, pericardial, peritoneal, and amniotic fluids; body fluids visibly contaminated with blood; along with all body fluids in situations where it is difficult or impossible to differentiate between body fluids; unfixed human tissues or organs (other than intact skin); HIV-containing cell or tissue cultures, organ cultures, and HIV- or HBV-containing culture media or other solutions; and blood, organs, or other tissues from experimental animals infected with HIV or HBV.

It’s clear that lab staff working with known BBP are protected by the BBP Standard. But what about other groups or workers? Who else should be protected by this standard, and who decides?

It is the employer’s responsibility to determine which staff have the potential of occupational exposure to BBP. If OSHA determines, on a case-by-case basis, that sufficient evidence of reasonably anticipated exposure exists, the employer will be held responsible for providing the protections of the BBP Standard to the employees with potential occupational exposure. When deciding which employees should be included in the BBP Standard, here are some groups of staff to consider:

• Housekeeping staff: Individuals who perform housekeeping duties, such as cleaning blood spills and handling regulated waste, have the potential for occupational exposure. These workers should be included in the exposure control plan. This includes staff who have the potential of handling soiled linens that could have bodily fluids on them.
• Janitors: If janitors are responsible for cleaning up blood spills, or handling trash that could be contaminated with bodily fluids, then they need the protection of the BBP Standard.
• Maintenance workers: This is another group lab leaders might not initially think needs to comply with the BBP Standard, but they could be exposed to BBP contamination in several ways. For example, if they are working in an operating laboratory doing maintenance work, there is always the opportunity for exposure because they are in the location where lab staff are actively working. If someone poured contaminated fluids down the drain (which of course, is not allowed, but unfortunately, sometimes still happens), a plumber could potentially be exposed while working on the sink or plumbing. Any staff spending a significant amount of time in a lab setting where exposure to BBP is a possibility should follow the BBP Standard because of the risk of exposure. Such exposure could also come from touching contaminated common areas such as telephones and shared computers, as well as the potential risk of exposure from the staff in the lab who are handling BBP.
• Lab staff that do not work with BBP: You may think that staff not handling any BBP do not require the protections of the BBP Standard. Keep in mind that even staff not handling potentially contaminated samples may still be exposed if someone working near them with bodily fluids has an accident, such as spilling a sample on the bench or on the floor. If samples possibly contaminated with BBP are being handled in a lab, lab leaders should consider whether staff not working with the samples could reasonably expect to be exposed to BBP. If that reasonable expectation exists in the work environment, then even staff not working with BBP samples must be included in the standard to ensure they receive proper immunizations and training to work safely in a lab environment where BBP are present.

Is anyone not covered by the OSHA BBP Standard?

• An employee who voluntarily performs a “Good Samaritan act” is not covered, because such an act isn’t considered a work-related exposure.⁴
• Volunteers and unpaid students are not covered. Compensated students are covered, but many laboratory environments have volunteers working in them. However, there are cases in which such unpaid workers would be covered by the BBP Standard. For example, if in your lab volunteers don’t handle blood themselves, but are exposed to an environment where staff around them are handling blood samples, it is the employer’s responsibility to identify the hazards and which lab staff could potentially be exposed. If there are volunteers in your lab who could reasonably be expected to have the potential of being exposed to blood and other bodily fluids, then it is the employer’s responsibility to ensure any such unpaid employees are protected by the BBP Standard. In this case, it’s clear the volunteers should be protected even though it’s not mandatory, according to OSHA.³

When it comes to protecting lab staff from BBP exposures, it’s much better to train anyone who may need it than to leave employees out of following the BBP Standard and later regret that decision. If you are unsure about which staff are required to be covered by the BBP Standard, contact the environmental health and safety team at your institution for guidance.

References:

1. Redmond, K. Rite Aid to develop bloodborne pathogen safety program following OSHA probe. NJBIZ.com, August 21, 2023.
2. Smart, A. Bloodborne Pathogen Exposure at Work. Nmshealth.com, January 4, 2023.
3. U.S. Department of Labor. www.OSHA.gov, Corrected November 8, 2011. https://www.osha.gov/laws-regs/regulations/standardnumber/1910/1910.1030
4. Kilbourne, C. OSHA’s BBP Standard: Your Questions Answered. Safety Daily Advisor, September 27, 2009.