Orthodontic wires as contaminated sharps

May 25, 1990
Ms. Carole Frings
Federal Agency Representative
American Dental Association
[Recipient address omitted]
Dear Ms. Frings:
This is in further response to your letter of March 20, addressed to Deputy Assistant Secretary, Alan McMillan. You requested a clarification from the Occupational Safety and Health Administration (OSHA) as to whether orthodontic wires are considered "sharps" under OSHA Instruction [CPL 2-2.69 ("Enforcement Procedures for the Occupational Exposure to Bloodborne Pathogens")] and 29 CFR 1910.141, OSHA's sanitation standard.
Although neither OSHA nor the Centers for Disease Control (CDC) defines saliva as an infectious body fluid, the CDC has determined that "during dental procedures contamination of saliva with blood is predictable" (MMWR June 24, 1988, 37:377-382, 387-388) and therefore saliva in dental settings should be considered potentially infectious.
OSHA's concern in this matter (as opposed to the Environmental Protection Agency) is to protect employees from puncture wounds which would expose them parenterally to potentially infectious body fluids. The ends of orthodontic wires can penetrate the skin. Since their contamination with blood can reasonably be anticipated, OSHA believes that they must be classified as "sharps" under the above referenced Instruction and standard and disposed of accordingly.
In your letter you referred specifically to an inspection which occurred in Michigan. As you are aware, the State of Michigan administers its own occupational safety and health program under a plan approved and monitored by Federal OSHA. As a condition of plan approval, States must assure that they will adopt, interpret, and enforce occupational safety and health standards that are either identical to or "at least as effective" as Federal standards or requirements. Because Dr. Ponitz and other employers in Michigan must comply with the requirements of the State, he may wish to contact the Michigan Department of Public Health at the following address for more information on the State's requirements:

Ms. Raj M. Wiener Director
Michigan Department of Public Health
3423 North Logan Street
Box 30195 Lansing, Michigan 48909
Telephone: (517) 335-8022

We hope this information is helpful to you.
Sincerely,
Gerard F. Scannell
Assistant Secretary
[Corrected 10/29/02]

[March 20 and March 22 requester letters reproduced on OSHA page; omitted here.]