Diseases rulemaking: OSHA unveils what’s coming soon
OSHA just pulled back the curtain to reveal a list of the key provisions that will appear in its upcoming Infectious Diseases proposed rule in the coming months! The sneak peek is thanks to a presentation at an OSHA advisory committee meeting. Compliance Network was there to bring you the scoop!
The rulemaking would not replace but supplement the existing Bloodborne Pathogens Standard in healthcare, healthcare support, and biomedical lab settings. Instead of bloodborne diseases, the new rule would provide protections from infectious agents transmitted by contact, droplet, and airborne routes. Examples include methicillin-resistant Staphylococcus aureus (MRSA), norovirus, influenza, and tuberculosis.
Which employers would be covered?
According to OSHA, the rulemaking is intended to protect workers who perform tasks that routinely expose them to infectious diseases. This means it would be applicable to biomedical labs and settings where any worker provides healthcare services or handles contaminated materials or human remains. Settings potentially include:
- Clinics embedded in a workplace or jobsite,
- Hospitals and physicians’ offices,
- Emergency medical services,
- Specialty ambulatory care,
- Home healthcare and long-term care facilities,
- Services that handle healthcare laundry or medical waste,
- Services that reprocess medical equipment,
- Biomedical labs, and
- Funeral homes.
Protections would be provided for workers that perform certain job tasks. These involve exposure to patients, clients, residents, contaminated materials, human remains, or infectious agents.
Key elements OSHA’s considering
The proposal would provide several major regulatory provisions:
- Workplace infection control plan (WICP), including hazard identification and policies/procedures;
- Recordkeeping;
- Reporting any fatalities/hospitalizations to OSHA;
- Multiple-employer responsibilities (e.g., construction work inside a healthcare facility);
- Costs for which employers are responsible; and
- Services available to workers at reasonable times/places.
The “policies/procedures” provision would cover:
- Screening and management (of patients, clients, residents, contaminated materials, and human remains;
- Cleaning, disinfection, and sterilization;
- Personal protective equipment;
- Engineering controls like ventilation;
- Employer support of worker vaccination;
- Worker medical management;
- Increased community transmission, outbreaks, and releases; and
- Worker training.
When an employer is engaged in construction inside covered settings, OSHA says:
- The employer that operates/controls the covered setting would provide the construction employer with information to ensure construction workers are not exposed to sources of an infectious agent; and
- Based on the shared information, the construction employers would be obligated to protect their workers under the existing 29 CFR 1926 Subpart C.
Proposal coming up
The proposed rule could be published in calendar year 2024. The latest semiannual agenda has the proposed rule slated for June 2024. Yet, that may be a little ambitious. Another official document that came out after the agenda — the “FY 2025 Congressional Budget Justification” for OSHA — has this one down for publication in fiscal year 2025. Technically, that’s still right around the corner because fiscal year 2025 starts on October 1, 2024.
Advisory committee approved proposal publication
Before it can publish a proposal, OSHA needs the green light from two of its advisory committees:
- Advisory Committee on Construction Safety and Health (ACCSH), and
- National Advisory Committee on Occupational Safety & Health (NACOSH).
On April 24, 2024, OSHA presented a summary and shared a background document for the Infectious Diseases proposal. A lengthy discussion followed. The committee talked about everything from small construction projects and exposure on rooftops to information sharing and the quality of training. ACCSH then gave OSHA a unanimous recommendation to publish the proposed rule.
However, the committee did so on the condition that OSHA make clear in the rule what information host employers must share with contractors that work at the site. That information would relate to infectious disease hazards and controls associated with the contractor’s work area.
NACOSH is scheduled to meet with OSHA on May 7, 2024. That committee is expected to also give the agency the proper endorsement to move ahead with publication of the proposal. Register for the virtual meeting if you’d like to attend.
Draft regulatory text has been around since 2014
The Infectious Diseases rulemaking has been on OSHA’s to-do list since the year 2010. A small business panel met in 2014 to review the agency’s 38-page draft regulatory text. However, at the time, the panel issued a report voicing concerns. In fact, the report resulted in a general recommendation that OSHA not issue a proposed rule on infectious diseases until the agency assessed information on the risk to each potentially covered task and workplace. That was long before the COVID-19 pandemic. Ever since, there’s been pressure on the agency to issue a rule.
Key to remember
We now have a clearer picture about what scope and regulatory elements will be in the soon-to-come Infectious Diseases proposal. Check out OSHA's presentation and supporting document.