Good Samaritan first aid, blood exposure, and sharps disposal

March 23, 2001

Mr. Dennis W. Ault

Aul-tech Life Safety

[Recipient address omitted]

Dear Mr. Ault:

Thank you for your January 30, 2001 letter to the Occupational Safety and Health Administration's (OSHA's) [Directorate of Enforcement Programs] regarding the applicability of the Bloodborne Pathogens Standard (29 CFR 1910.1030) to employees providing first-aid or cardiopulmonary resuscitation (CPR) as "Good Samaritans." We appreciate the clarification that you provided to a member of our staff over the phone. We hope this letter further serves your needs. Your questions are rephrased below followed by OSHA's response. This letter constitutes OSHA's interpretation only of the requirements discussed and may not be applicable to any question not delineated within your original response.

1. In a non-medical office situation, if an exposure incident (specific eye, mouth, mucous membrane or parenteral contact with blood or other potentially infectious materials (OPIM)) occurs due to employees providing first aid or CPR of their own free will (as "Good Samaritans");

A) Who is responsible for paying for testing?

B) Must the employer keep a record of the exposure (for how long)?

C) Would this exposure be covered under worker's compensation?

As you know, the Bloodborne Pathogens Standard applies to "all reasonably anticipated occupational exposures to blood or OPIM." Exposure is usually not anticipated in a non-medical office setting. If an employee is providing first aid or CPR as a Good Samaritan and not as a trained first aider, designated to perform first aid by the employer, that employee is not covered by the standard. Therefore, if an employee has an exposure incident while acting as a Good Samaritan, the employer is not required by the standard to provide the HBV vaccination series, post-exposure evaluation, follow-up procedures according to the current U.S. Public Health Service guidelines, or any other protections of the standard, although OSHA encourages employers to do so.

~~Assuming that the office is not covered by the bloodborne pathogens standard, the recording of an exposure incident may be required by the current recordkeeping regulations in Part 1904. The office is required to record an exposure incident on the log according to 29 CFR 1904, Recording and Reporting Occupational Injuries and Illnesses, if: (1) the incident is a work-related incident that involves loss of consciousness, transfer to another job, or restriction of work or motion, (2) the incident results in the recommendation of medical treatment beyond first aid (e.g., gamma globulin, hepatitis B immunoglobulin, hepatitis B virus vaccine, or drugs needed to prevent HIV infection), regardless of dosage, or (3) the incident results in a diagnosis of seroconversion. The serological status of the employee shall not be recorded on the OSHA 200; the case shall be recorded as an injury. The records must be kept in the establishment for five years following the end of the year to which they relate.~~ We can not address your question concerning the payment of post-exposure follow-up and testing by worker's compensation. You should contact your compensation or insurance carrier or state worker's compensation program for that information.

[This document was edited on 2/7/03 to strike information that no longer reflects current OSHA policy. Please see the revised Injury and Illness Recordkeeping Standard, 1904 on OSHA's Recordkeeping Page.]

2. If an employee uses or produces contaminated sharps or other materials for personal medical reasons (e.g., person with diabetes using insulin syringes and blood test strips), who is responsible for providing the sharps containers for that employee? Can the employer compel the employee to provide their own sharps container?

Again, the Bloodborne Pathogens Standard only applies to occupational exposure to blood. The employer would not be required to provide a sharps container to an employee using insulin syringes for personal therapeutic reasons. In order to eliminate potential exposures to other workers, the employer should strongly insist that the employee have his or her own sharps container and bring that with them to the workplace.

Thank you for your interest in occupational safety and health. We hope you find this information helpful. OSHA requirements are set by statute, standards and regulations. Our interpretation letters explain these requirements and how they apply to particular circumstances, but they cannot create additional employer obligations. This letter constitutes OSHA's interpretation of the requirements discussed. Note that our enforcement guidance may be affected by changes to OSHA rules. Also, from time to time we update our guidance in response to new information. To keep apprised of such developments, you can consult OSHA's website at http://www.osha.gov. If you have any further questions, please feel free to contact the [Office of Health Enforcement] at (202) 693-2190.

Sincerely,

Richard E. Fairfax, Director

[Directorate of Enforcement Programs]

[Correction 2/20/2003]