Bloodborne-pathogen duties for emergency responders and Ryan White Act

September 12, 1995

Ms. Katherine West, B.S.N., MSED, CIC
Infection Control Consultant
Infection Control/Emerging Concepts, Inc.
[Recipient address omitted]
Dear Ms. West:

This is in further response to your letter of December 22, 1994, addressed to Susan Harwood of the Occupational Safety and Health Administration (OSHA). We apologize for the delay in our response. Your letter was forwarded to the Office of Health Compliance Assistance (OHCA), for our response. Your question concerns the applicability of the Bloodborne Pathogens standard, 29 CFR 1910.1030, to emergency response employees (ERE) as defined under the Centers for Disease Control and Prevention (CDC), Ryan White Comprehensive AIDS Resources Emergency Care Act (PL 101-381), in the state of Virginia.

You asked: "Do the OSHA Bloodborne Pathogens regulations (29 CFR Part 1910.1030) supersede the Ryan White Law (PL 101-381, 3-21-94 Fed.Reg.) with regard to the Emergency Response portion of the law?" and, if applicable, whether or not the OSHA Bloodborne Pathogens standard requires that a "licensed health care professional" make the determination of the occurrence of an exposure incident.

As you know, the Virginia Department of Labor and Industry operates its own occupational safety and health program under a plan approved by the U.S. Department of Labor in accordance with section 18 of the Occupational Safety and Health Act of 1970. Although the Act specifically excludes the employees of state and local governments from coverage by OSHA, the state plan must include comprehensive coverage of state and local government employees, including the emergency response employees (EREs) of the Fairfax County Fire and Rescue Department.

OSHA's Bloodborne Pathogens standard was adopted by the Virginia program, and both public and private employers in Virginia are subject to the requirements of the standard. Part III (A)(2) of the Ryan White Care Act specifically states that the OSHA Bloodborne Pathogens standard "...may be mandatory for some EREs, depending on whether they are employed in the public or private sector and whether the State ... has an approved occupational safety and health plan." In Virginia and other states with OSHA-approved safety and health plans, public employers are required to comply with the Bloodborne Pathogens standard.

The Bloodborne Pathogens standard does not require that a "licensed health care professional" make the initial determination of an exposure incident. The citation issued to the Fairfax County Fire and Rescue Department involved the employer not ensuring post-exposure medical evaluations and treatments by a licensed physician or health care professional after an exposure incident. This is not the same as the Ryan White Care Act requirements in Addendum A, Section 300ff-83(b), regarding "Initial Determination by Designated Officer."

Should you have any further questions on this, matter please contact [the Office of Health Enforcement at (202) 693-2190].

Sincerely,
Ruth McCully, Director
Office of Health Compliance Assistance

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[Corrected 12/6/2024]