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Standard Interpretations
05/22/2007 - Application of OSHA's Bloodborne Pathogens standard to contractors who clean up blood following accidents.

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• Standard Number: 1910.1030; 1910.1030(b); 1910.1030(d)(4)(iii)(B); 1910.1030(d)(4)(iii)(C); 1910.1030(g)(1); 1910.1030(g)(1)(i); 1910.1030(g)(1)(i)(E); 1910.1030(g)(2)(vii)(M)


May 22, 2007

Mr. Dave Middleton
75 Garden Drive
Montgomery, IL 60538

Dear Mr. Middleton:

Thank you for your January 11, 2007 letter to the Occupational Safety and Health Administration (OSHA). Your inquiry was forwarded to OSHA's Directorate of Enforcement Programs (DEP) for a response. You had specific questions regarding the applicability of OSHA's Bloodborne Pathogens standard, 29 CFR 1910.1030, to contractors who clean up blood following accidents. This letter constitutes OSHA's interpretation only of the requirements discussed and may not be applicable to any question not delineated within your original correspondence. For clarification, your specific question is paraphrased below, followed by OSHA's response. We apologize for the delay in responding to your questions.

Scenario: I have a cleaning company that will be involved in cleaning up blood and body fluids after homicides, suicides, and unattended deaths. The cleaning crew will contact blood and body fluids that have been exposed to air, in most cases, for at least 24 hours and will be using hospital-grade disinfection solutions that will kill HIV, hepatitis B virus, and hepatitis C virus.

Question 1: Does this type of cleaning fall under the Bloodborne Pathogens standard (BBP)?

Reply 1: Yes, the Bloodborne Pathogens standard would be applicable to the cleanup work done by your employees. 29 CFR 1910.1030(b) defines "occupational exposure" as "reasonably anticipated skin, eye, mucous membrane, or parenteral contact with blood or other potentially infectious materials [OPIM] that may result from the performance of an employee's duties." The standard is concerned about exposure to blood regardless of how long it has been exposed to air, and, therefore, the exposure determination for your cleaning crew must be made without regard to the potential 24-hour delay between the time of the blood spill and the time of the cleanup activity. There are studies stating that many bloodborne pathogens are infectious for some time on environmental surfaces. For example, the hepatitis B virus (HBV) is likely to survive longer than two weeks, and hepatitis C virus can survive for up to two weeks.

Question 2: Regarding the waste generated from the cleanup operation, the Illinois EPA does not classify this waste to be potentially infectious medical waste (PIMW) under its statutes. I have been told that since my operation does not involve treatment or diagnosis of patients, I may dispose of the byproduct of the cleanup in a local landfill. Local landfills in my state will not accept containers or bags with biohazard labels. If my work falls under the BBP standard, must the waste generated from the cleanup be placed in containers which are marked or labeled as biohazard or can we simply place the waste in color-coded (red) garbage bags?

Reply 2: With regard to the waste generated from the cleanup of blood as described in your letter, OSHA regards this as "regulated waste" under the Bloodborne Pathogens standard. [See the definition of "regulated waste" in 29 CFR 1910.1030(b).] Because the standard is based on the concept of "universal precautions," an approach to infection control under which "all human blood and certain human body fluids are treated as if known to be infectious for HIV, HBV [hepatitis B virus], and other bloodborne pathogens," [29 CFR 1910.1030(b)], the blood or OPIM to which any particular employee is exposed must be presumed to be infectious. The standard requires that regulated waste other than contaminated sharps be placed in containers which are: (1) closable; (2) constructed to contain all contents and prevent leakage of fluids during handling, storage, transport or shipping; (3) labeled or color-coded in accordance with paragraph (g)(1)(i); and (4) closed prior to removal to prevent spillage or protrusion of contents during handling, storage, transport, or shipping [29 CFR 1910.1030(d)(4)(iii)(B)].

There are three exemptions to the labeling requirement of paragraph (g)(1)(i). The first exemption, paragraph (g)(1)(i)(E), allows the substitution of red bags for labels on bags or containers of regulated waste. OSHA believes that employees will be protected where red bags are used because employers will have to comply with paragraph (g)(2)(vii)(M) of the standard which requires that employees be trained to understand the meaning of all color coding used to comply with paragraph (g)(1). This would include information on the meaning of red bags, thus assuring that OSHA's intent, to inform employees of hazards present at their worksite, would be achieved by red bagging.

Please be aware that according to 1910.1030(d)(4)(iii)(C), "[d]isposal of all regulated waste shall be in accordance with applicable regulations of the United States, States and Territories, and political subdivisions of States and Territories." As you stated in your letter, you have inquired and received information from the Illinois EPA that waste generated from your cleanup activities are allowed, in your state, to be disposed of in local landfills provided that they are not labeled "Biohazard." As stated above, OSHA's requirements will be met with the use of red bags in lieu of biohazard labels on containers of regulated waste and with appropriate training of affected employees.

Thank you for your interest in occupational safety and health. We hope you find this information helpful. OSHA requirements are set by statute, standards, and regulations. Our interpretation letters explain these requirements and how they apply to particular circumstances, but they cannot create additional employer obligations. This letter constitutes OSHA's interpretation of the requirements discussed. Note that our enforcement guidance may be affected by changes to OSHA rules.

Also, from time to time we update our guidance in response to new information. To keep apprised of such developments, you can consult OSHA's website at http://www.osha.gov.

If you have any further questions, please feel free to contact the Office of Health Enforcement at (202) 693-2190.

Sincerely,



Richard E. Fairfax, Director
Directorate of Enforcement Programs


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