Unmasking the top three OSHA violations for bloodborne pathogens
OSHA’s Bloodborne Pathogens standard at 29 CFR 1910.1030 has been around for decades, but it remains a source of confusion for employers. In fact, OSHA cited the standard almost 3,000 times in the last two fiscal years, making it a frequently violated standard in Part 1910.
Who’s covered?
If you have employees with occupational exposure, you have obligations under the standard. “Occupational exposure” refers to reasonably anticipated contact with blood or other potentially infectious materials (OPIM) that may result from the performance of an employee’s duties.
While most employers mistakenly associate bloodborne pathogens with “just” healthcare, you don’t have to be in the healthcare industry to come under the standard. For example, first-aid team members, custodians and maintenance workers, housekeeping and laundry personnel, laboratory technicians, correctional and law enforcement officers, and others may have occupational exposure too. It’s the employer's responsibility to determine which job classifications or specific tasks and procedures involve reasonably anticipated contact with blood or OPIM.
Which requirements trip employers up the most?
Once you figure out that you have employees with occupational exposure and that 1910.1030 applies, it may be helpful to know where your peers go wrong. It turns out the top three trouble spots for 1910.1030 violators in fiscal years 2023 and 2024 were:
- Paragraph (c) — Exposure control plan and exposure determination,
- Subparagraph (g)(2) — Information and training, and
- Paragraph (f) — Hepatitis B vaccination and post-exposure evaluation and follow-up.
We cover these three in more detail below; however, note that recordkeeping and compliance methods at 1910.1030(h) and (d), respectively, rounded out the top five violative paragraphs under the standard.
#1 Violation: Failure to develop and maintain an exposure control plan, including an exposure determination, 1910.1030(c)
OSHA requires a written plan to eliminate or minimize employee exposure. Covered employers must include:
- An exposure determination per 1910.1030(c)(2);
- A schedule and method of implementing paragraphs (d), (f), (g), and (h) of 1910.1030; and
- A procedure to evaluate circumstances surrounding exposure incidents.
The plan must be reviewed annually and as necessary to reflect changes in tasks, procedures, and positions that affect occupational exposure, as well as technological changes that eliminate or reduce occupational exposure. Annually, employers also must document in the plan that they have:
- Considered and begun using appropriate, commercially-available, effective safer medical devices designed to eliminate or minimize occupational exposure; and
- Solicited input from front-line employees in identifying, evaluating, and selecting effective engineering and work practice controls.
#2 Violation: Failure to provide effective information and training, 1910.1030(g)(2)
Employers must ensure that their employees with occupational exposure receive initial training that covers all elements in paragraph (g)(2) of the standard. This is prior to being placed in positions where occupational exposure may occur. Training must also be offered at least annually thereafter, and when new or modified tasks or procedures affect an employee’s occupational exposure.
However, HIV and HBV laboratory and production facility employees must receive specialized initial training, in addition to the training provided to all employees with occupational exposure.
It’s important (and required) that training be presented at an educational level and in a language that employees understand and that employees have the opportunity to ask the trainer questions. A trainer knowledgeable in the training elements as they relate to the workplace is mandated as well.
#3 Violation: Failure to offer hepatitis B vaccination and post-exposure evaluation and follow-up, 1910.1030(f)
Employers must offer the hepatitis B vaccine to employees with occupational exposure after the employees have received training and within 10 days of initial assignment to a job with occupational exposure. Employees who decline to accept the vaccination must sign the statement in 1910.1030 Appendix A.
If an occupationally exposed employee suffers an exposure incident, then post-exposure evaluation and follow-up must be made available. An “exposure incident” is a specific eye, mouth, other mucous membrane, non-intact skin, or parenteral contact with blood or OPIM. The evaluation and follow-up must be at no cost to the employee and include:
- Documenting the route(s) of exposure and the circumstances under which the exposure incident occurred;
- Identifying and testing the source individual for HBV and HIV infectivity, if the source individual consents or the law doesn’t require consent;
- Collecting and testing the exposed employee’s blood, if the employee consents;
- Offering post-exposure prophylaxis;
- Offering counseling; and
- Evaluating reported illnesses.
After evaluating the employee, the healthcare professional will provide a limited written opinion to the employer, but it will not offer any medical findings or diagnoses.
Key to remember: If you have employees with occupational exposure, you’re covered by the Bloodborne Pathogens standard and must comply with all the requirements outlined in 1910.1030. The top three trouble spots for violators in fiscal years 2023 and 2024 involved the written plan, employee training, and vaccination/evaluation.