October 2, 1992

Mr. Emil Hansel
Chief Financial Officer
1515 South Federal Highway
Suite 210
Boca Raton, Florida 33432

Dear Mr. Hansel:

This is in response to your letter of May 1, requesting clarification of the Occupational Safety and Health Administration (OSHA) regulation, 29 CFR 1910.1030, "Occupational Exposure to Bloodborne Pathogens." Your question involves application of the regulation to your nursing personnel service, Cross Country Healthcare Personnel (CCHP), which provides Registered Nurses to hospitals for temporary assignments.

OSHA considers personnel providers which send their own employees to work at other facilities to be employers whose employees may be exposed to hazards. Since it is your company, CCHP, which maintains a continuing relationship with its employees but another employer (your client) who creates and controls the hazards, there is a shared responsibility for assuring that your employees are protected from workplace hazards. The client employer has the primary responsibility for such protection, but the "lessor employer" likewise has a responsibility under the Occupational Safety and Health Act.

In meeting the requirements of OSHA's standard on bloodborne pathogens, the lessor employer would, for example, be expected to provide the generic training required by the standard and to ensure that employees are provided with the required vaccinations and that proper follow-up evaluation is provided following an exposure incident. Client employers would then be responsible for providing site-specific training and personal protective equipment and would have the primary responsibility to control potential exposure conditions. The client, of course, may specify what qualifications are required for supplied personnel, including vaccination status. Likewise, a company such as yours may specify and require similar qualifications for physicians it employs for placement. Your contracts with your client employers and the physicians should clearly describe the responsibilities of both parties in order to ensure that all requirements of the regulation are met.

Your second question addresses what training is required to be performed by CCHP as your recruitment process does not include direct contact with your nursing personnel. Self-study modules, videos and interactive training programs may all be used as a part of the training program. However, the training must be tailored to the language and educational levels of the employees, and the trainees must be given the opportunity for interactive questions and answers. It should be pointed out that the training does not have to be provided by the employer's staff. An employer could arrange with a local hospital to provide the training through its regular in-service educational program or the contract could specify that all training will be done by the client employer. In the latter case, it would be the responsibility of the "lessor employer" to develop some means of ensuring that the required training is, in fact, being given.

We hope this information is responsive to your concerns. If you have any further questions, please contact our Regional Bloodborne Pathogens Coordinator in Atlanta at (404) 347-2281. Thank you for interest in worker safety and health.

Sincerely,



Roger A. Clark,
Acting Director
Directorate of Compliance Programs