OSHA Rules for Hazards in Healthcare

Posted on 4/16/2018 by Joel Gregier, CDGP

healthcareBLOG.jpgWhen you think of the most hazardous workplaces, you might be inclined to think construction or manufacturing. While those workplaces certainly do have appreciable rates of injuries and illnesses, the Bureau of Labor Statistics (BLS) has shown that hospital workers face a higher likelihood of injury or illness resulting in days away from work than workers in the construction or manufacturing sectors.

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BLS reported that in 2016 there were 552,600 non-fatal injuries and illnesses in the healthcare sector. This topped the list, with manufacturing coming in second at 410,500. Healthcare safety efforts are challenged in both the diversity of employees to protect as well as the unique hazards faced by the employees.

Healthcare services require a broad range of workers, such as physicians, nurses, technicians, clinical laboratory workers, first responders, building maintenance, security and administrative personnel, social workers, food service, housekeeping, and mortuary personnel.

Identifying Healthcare Hazards

Healthcare workers face both traditional workplace safety hazards (e.g., slips and falls) and many that are unique to their workplace activities. These unique healthcare hazards can include:
  • Biological hazard exposure, such as bloodborne pathogens and medical waste.
  • Chemical hazard exposure, such as chemotherapy and other drugs, sterilizers and disinfectants (e.g., ethylene oxide, glutaraldehyde, and formaldehyde), and anesthetic gases.
  • Musculoskeletal hazards, especially related to patient handling.
  • Ionizing and non-ionizing radiation (e.g., x-rays, nuclear medicine, lasers).

OSHA’s Bloodborne Pathogens Standards at 29 CFR 1910.1030

blood-blood.JPGOf the OSHA safety standards impacting hospitals and other healthcare facilities, the Bloodborne Pathogens Standard at 40 CFR 1910.1030 is probably the most recognizable. It’s also one of the most unique.

Infectious disease transmission in the healthcare setting can be through direct or indirect contact (e.g., skin-to-skin or transfer to patient care instruments), droplet, and airborne. Hospital safety efforts to reduce the spread of infectious diseases must comply with several workplace safety regulations. OSHA’s Bloodborne Pathogens Standard is designed to protect employees from blood and other potentially infectious materials.

Hospitals and other healthcare facilities where employees may be exposed to bloodborne pathogens must develop a written Exposure Control Plan to describe the efforts to eliminate and reduce employee exposure. Simply stated, the Bloodborne Pathogens Standard is implemented through four primary efforts:
  1. Universal precautions
  2. Engineering and work practice controls
  3. Hazard communication
  4. Employee training

What Are Universal Precautions (UP) for Infection Control?

Universal precautions (UP) were originally recommended by the CDC in the 1980s as an approach to infection control to protect workers from HIV, HBV, and other bloodborne pathogens in human blood and body fluids. Under universal precautions, all human blood and certain human body fluids are treated as if they are known to be infectious. [29 CFR 1910.1030(d)(1)] Healthcare safety goes beyond universal precautions addressed in this OSHA safety standard. UP are now used in combination with standard precautions and transmission-based precautions.

As with other workplace hazards, employers should seek to eliminate or minimize employee exposure. Engineering controls and work practice controls work in concert to accomplish this goal. [29 CFR 1910.1030(d)(2)]

Hazard Communication (HazCom) in Healthcare

The Bloodborne Pathogens Standard requires employers to communicate the presence of bloodborne pathogens. This may include specific labels and symbols posted on containers, refrigerators, or devices holding potentially infectious materials, including samples of blood and other body fluids and medical waste. [29 CFR 1910.1030(g)(1)(i)]

Safety Training for Healthcare Workers

Healthcare employers must conduct initial and annual training to employees with occupational exposure. [29 CFR 1910.1030(g)(2)] Training, in combination with hospital safety efforts like engineering and work practice controls, is an effective means of ensuring healthcare workers’ hazard exposure is minimized.

Not all bloodborne pathogens or medical waste hazards can be engineered away.

In addition to the Bloodborne Pathogens Standard, healthcare safety professionals will need to comply with OSHA safety standards for personal protective equipment (29 CFR 1910.132) and respiratory protection (29 CFR 1910.134). These standards also contain a training requirement to ensure the employee understands the hazards they face, as well as the proper use and care and limitations of the specified equipment.

OSHA has more information regarding healthcare safety on its web site.

Convenient OSHA Training for Healthcare Workers

The Bloodborne Pathogens Online Course is designed to meet OSHA’s initial or annual training requirement for employees who may be exposed to blood or other infectious materials in the workplace. The course covers the dangers of bloodborne pathogens, common means of transmission, and control measures to prevent exposure.

Get up to speed on the latest OSHA rules for protecting yourself and your employees and colleagues on the job with convenient, interactive online courses at Flexible, 24/7 access allows you to stop and start to fit your work schedule. Get access to digital resources, interactive lessons and exercises that reinforce critical safety practices, and IT support when you need it—7 days a week. Browse the catalog now at

Tags: communication, hazard, healthcare, osha, PPE, universal precautions

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