Protective sleeves and gloves in clinical work

January 19, 2010

Mrs. Vivian Ericksen

[Recipient address omitted]

Dear Mrs. Ericksen:

Thank you for your letter to the Occupational Safety and Health Administration (OSHA). Your letter was forwarded to (OSHA's) Directorate of Enforcement Programs (DEP) for a response. You raised concerns regarding the adequacy of wrist-length disposable gloves used in clinical practice when treating patients infected with communicable diseases such as genital herpes and hepatitis. You suggested that elbow-length personal protective equipment (PPE) would be a more protective alternative. This letter constitutes OSHA's interpretation only of the requirements discussed and may not be applicable to any question(s) or scenarios not delineated within your original correspondence.

We would like to assure you that OSHA shares your concern for the safety of healthcare workers in performing their jobs which often place them in direct contact with infectious agents. To that end, OSHA has set requirements in its Bloodborne Pathogens Standard, 29 CFR 1910.1030, which directly address protection of employees and require that "appropriate" PPE be provided at no cost to employees exposed to blood or other potentially infectious materials (OPIM). It is an employer's responsibility to determine what constitutes "appropriate" PPE based on the tasks and potential exposures anticipated during the performance of an employee's duties. In situations where long sleeves are required to protect workers from splashes that may go beyond the wrist, such equipment (e.g., disposable impervious sleeves or gowns) must be provided.

In addition to the protections prescribed by the Bloodborne Pathogens Standard, OSHA's Personal Protective Equipment Standard, 29 CFR 1910.132, requires that all employers perform a hazard assessment to determine where hazards exist that necessitate the use of PPE. This standard further requires affected employers to select and assure the use of the types of PPE that are identified in the hazard assessment. [29 CFR 1910.132(d)(1)(i)] We assure you that these requirements are applicable to hazards encountered by healthcare workers and would apply where sleeves or gowns are deemed necessary to protect workers from infectious diseases that do not fall under the coverage of the Bloodborne Pathogens Standard.

The State of Nevada administers its own occupational safety and health program under a plan approved and monitored by Federal OSHA. Under this plan, Nevada promulgates and enforces occupational safety and health standards, including a bloodborne pathogens standard identical to the Federal standard. For information on enforcement of the bloodborne pathogens standard in Nevada, you may contact the State OSHA program at:

Steve Coffield, Chief Administrative Officer

Nevada OSHA

1301 N. Green Valley Parkway, Suite 200

Henderson, NV 89074

Telephone: (702) 486-9020

Fax :(702) 990-0365

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