July 22, 1992

Laurel H. Trice, RN, BSN
Bayada Nurses
290 Chester Avenue
Moorestown, New Jersey 08057

Dear Ms. Trice:

This is in response to your letter of June 26, addressed to Dorothy Strunk, Acting Assistant Secretary, regarding the Occupational Safety and Health Administration (OSHA) standard 29 CFR 1910.1030, "Occupational Exposure to Bloodborne Pathogens."

You state that your company, Bayada Nurses, a home health care agency, has identified employees who are at risk of occupational exposure and has provided information and training about hepatitis B as well as offered the vaccine to all of those employees. Your concern, however, is that other employers similar to Bayada are not providing training or the vaccinations to their home health aids because they are at "low risk"; you therefore asked for an interpretation of the requirements. According to your letter, it is your company's understanding "that the law states that the training and the offer to vaccinate must occur prior to a potential exposure incident, even if the risk is low." Your understanding is correct.

The Bloodborne Pathogens Standard requires that every employer perform an exposure determination as part of his or her exposure control plan. This determination must delineate the job classifications or specific tasks and procedures an employee may perform which constitute occupational exposure. "Occupational exposure" is defined in the standard 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." Those employees with occupational exposure are covered by all requirements of the standard.

As you know, OSHA has jurisdiction over employee safety and health and its applicable regulations cover all employers, regardless of the work setting. OSHA has identified and cited some residential care providers who are not in compliance with the Bloodborne Pathogens Standard, and we intend to continue our enforcement of this standard.

We hope this information is responsive to your concerns. Thank you for your interest in employee safety and health.

Sincerely,



Patricia K. Clark, Director
Directorate of Compliance Programs