Bloodborne pathogen coverage at residential care facilities

May 12, 1992

Ms. Eva Park
Director of Nurses
Homestead
[Recipient address omitted]
Dear Ms. Park:

This is in response to your February 25, letter concerning the applicability of 29 CFR 1910.1030, "Occupational Exposure to Bloodborne Pathogens," to your intermediate care facility for the mentally retarded. You inquired whether all of the provisions of the regulation are applicable to your facility or whether, due to hepatitis B testing of residents, the vaccine requirement could be waived.

The public record supporting this regulation shows that developmentally disabled adults who are or have been institutionalized have an increased risk for hepatitis B infection and that in 1990 the Centers for Disease Control recommended the hepatitis B vaccine for both the clients and staff of institutions for the developmentally disabled.

While OSHA does not permit an exemption to any requirement of the standard based on testing of residents, you should note that it is the employer's responsibility to determine which job categories or tasks and procedures involve occupational exposure. Occupational exposure is defined as reasonably anticipated exposure to blood or other potentially infectious materials as the result of performing job duties. Employees who do not have occupational exposure are not covered by the scope of this standard.

In an ambulatory residential facility, only certain employees may have jobs which involve occupational exposure although OSHA expects an employer such as yourself to take into account the possibility of biting and scratching when determining which, if any, employees in your facility have occupational exposure. Those employees for whom it can be reasonably anticipated that they will have exposure to blood or other potentially infectious materials during the course of their job duties are covered by all sections of the regulation, including the vaccine requirement.

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

Sincerely,
Dorothy L. Strunk
Acting Assistant Secretary