Bloodborne pathogen labels, needle recapping and uniforms

September 15, 1992

Ms. Kathy Hogan, RN
St. Joseph's Hospital
Infection Control
[Recipient address omitted]
Dear Ms. Hogan:

This is in response to your letter of April 21, requesting clarification of three issues concerning the requirements of the Occupational Safety and Health Administration (OSHA) standard, 29 CFR 1910.1030, "Occupational Exposure to Bloodborne Pathogens." Your specific questions are referenced and addressed in the order of your letter. We apologize for the delay in this response.

Your first question concerns the labeling or color-coding of laundry which is handled by means of universal precautions. This issue is addressed by paragraphs 1910.1030(d)(4)(iv)(A)(2) and 1910.1030(d)(4)(iv)(C), which state that when a facility utilizes universal precautions in the handling of all soiled laundry, alternative labeling or color-coding is allowable. You state in your letter that you utilize universal precautions and do not red bag or label your laundry. In order to be in compliance with this standard, some form of coding or labeling must be instituted.

Alternative labeling or color-coding is sufficient if it permits all employees to recognize the containers as requiring compliance with Universal Precautions. The alternate label or color-code may also be used if the facility ships contaminated laundry off-site to a second facility which also utilizes universal precautions in the handling of all laundry.

With respect to your second question regarding the OnGard needle recapping device used in your psychiatric units, paragraphs 1910.1030(d)(2)(vii)(A) and 1910.1030(d)(2)(vii)(B) prohibit recapping of needles unless no alternative is feasible or recapping is required by a specific medical procedure. When recapping must be performed, it must be accomplished by the use of a mechanical device or a one-handed technique.

Further, the standard requires each employer to establish an exposure control plan "designed to eliminate or minimize employee exposure." If the medical practices require recapping or removal of sharps or if no alternative, such as immediate discarding into an approved sharps container, is feasible, the exposure control plan must include a provision for the use of mechanical devices in these circumstances. Although OSHA cannot, of course, approve or endorse particular products, the OnGard recapper appears to be an acceptable mechanical recapping device.

In a psychiatric unit, it may be infeasible to locate a standard sharps container in certain areas. You may consider alternatives, such as using containers which are lockable or are designed to prevent removal of syringes while still maintaining easy accessibility for discarding or having the healthcare worker bring a sharps container to the site, perform the procedure, and then remove the container upon leaving. The final determination regarding compliance with OSHA requirements, however, will be made in the workplace after an OSHA compliance officer observes employees utilizing a particular product and conducts employee interviews.

Your third question concerns providing and laundering "uniforms." The standard requires the provision and laundering only of garments that are personal protective equipment (PPE). If an employee's uniform does not serve as PPE and if the employee has occupational exposure which requires additional PPE to protect the uniform, then the uniform would not be covered by the standard the protective garments would be covered. If, however, a uniform provides an appropriate level of protection for workplace conditions and is worn, relied upon, and/or functions as a protective garment, the uniform would be covered by the standard. In either case, the protective garments must be provided, laundered, repaired and replaced by the employer in accordance with sections 1910.1030(d)(3)(i), 1910.1030(d)(3)(ii), 1910.1030(d)(3)(iii), 1910.1030(d)(3)(iv) and 1910.1030(d)(3)(v).

It is the employer's responsibility to determine whether there is occupational exposure and what, if any, personal protective equipment is appropriate. PPE will be considered "appropriate" only if it does not allow blood or other potentially infectious materials (OPIM) to pass through or to reach the employees' work clothes, street clothes, undergarments, skin, eyes, mouth, or other mucous membranes under normal conditions of use and for the duration of time when the protective equipment will be used.

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

Sincerely,

Patricia K. Clark, Director
[Directorate of Enforcement Programs]

[Corrected 6/2/2005]