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OSHA to Propose Infectious Disease Program Standard

Posted August 8, 2011

On July 29 OSHA held an informal stakeholder meeting to solicit comments on a possible infectious disease program standard. More than 60 participants representing hospitals, unions, public health organizations, government agencies and trade organizations attended the meeting. NFDA Senior Vice President of Advocacy John Fitch and NFDA OSHA Special Counsel Edward M. Ranier, Esq., represented funeral service at the meeting.

At the start of the meeting, Dr. David Michaels, assistant secretary of Labor for OSHA, stated that the purpose of the meeting was to focus on airborne infectious diseases and skin contact exposure that were not covered by the existing OSHA bloodborne pathogen standard. He stated that OSHA is considering a vertical standard that would focus on employee protection for specific industries and workplace settings and would cover airborne, droplet and contact exposure to infectious agents, such as MRSA.

The discussion focused on several key areas:

1. The scope of a proposed infectious disease standard. The scope of the proposed standard, if adopted, would cover healthcare workplaces and workers. "Healthcare workers" would be broadly defined and cover any worker directly involved in patient care, such as doctors and nurses in hospitals, and workers exposed in related tasks, such as patient support personnel, infectious waste handlers and laboratory services.

The focus of the standard would be on workplaces where workers would have "reasonably anticipated contact" with infectious diseases through direct contact, droplet contact or airborne exposure. The standard would not rely on a list of specific infectious agents.

OSHA specifically stated that the proposed standard would include funeral homes/mortuaries.

The employer would be required to determine the specific infectious agents employees would be exposed to at job site. The new standard would not replace the bloodborne pathogen standard. Employers would be required to provide personal protective equipment to workers without cost.

2. A workplace infection control plan as a method of compliance. The written infection control plan that is envisioned by OSHA may be merged with the exposure control plan currently required under the bloodborne pathogen standard. The plan would have to contain:

  • A list of procedures to protect workers.
  • Processes for analyzing infectious agents.
  • Prompt identification of jobs or tasks in which workers could be exposed to infectious agents.
  • Communication of hazards to employees.
  • Medical surveillance
  • Infection control, beginning at the first contact.
  • A hierarchy of controls, such as those required in other standards, including engineering controls, administrative controls and personal protective equipment.

Laboratory exposure would be governed by NIH guidelines. The written infection control plan would have to be readily accessible and reviewed and updated annually.

NFDA representatives raised a concern about how small business could comply with these requirements, especially funeral homes that had fewer than 10 employees.

3. Medical screening, surveillance and vaccination. The infectious disease program standard would require medical screening, medical surveillance and vaccination. Employers would be required to train employees about specific infectious diseases to which they are exposed and the need for vaccination. Colds and seasonal flu would be exempt from the vaccination requirements. Any required inoculations for infectious diseases specific to a worksite would be at the employer's expense. Employees would be able to decline vaccination by signing a declination form.

The medical surveillance portion of the proposed standard would require a means to report exposure incidents and obtain medical recommendations from physicians who treat exposed workers.

NFDA representatives raised concerns about the cost of this requirement and employers' liability should an employee decline a vaccination because of personal, religious or cultural beliefs and practices, especially if vaccinations were a condition of employment.

4. Communication of hazards to employees and training. OSHA representatives indicated that there would be signage and labeling requirements for infectious agent at the worksite; there would also be signage and labeling requirements related to the handling and transportation of hazardous materials.

Annual training would be required for affected employees and would cover infectious disease recognition, transmission of specific infectious diseases at the worksite, the need for vaccinations and the use of personal protective equipment. Training under the new standard would be during working hours and at no cost to employees.

Employees would also have to be trained whenever a new hazard is introduced, a task or procedure changes, or a new control method is introduced. The training would have to be conducted by a knowledgeable person in the language and at the literacy level of employees.

NFDA raised the issue of cost and compliance by small businesses. NFDA representatives that larger employers have the personnel and resources to comply with the requirements, however, the average funeral home does not.

5. Record keeping. OSHA indicted that, in addition to medical records such as vaccination studies, the employer would have to maintain records of exposure incidents.

NFDA representatives raised a question about the need for an incident log for employers, such as funeral homes, who are exempt from maintaining a sharps injury log (under the blood borne pathogen standard) because of their excellent safety record. NFDA representatives urged that employers who are currently exempt from OSHA recordkeeping requirements should also be exempt from maintaining a separate exposure incident log under an infectious disease standard.

At some point, OSHA will propose a new infectious disease program standard and ask for public comments and hold a public hearing. Rest assured that NFDA will be actively engaged in this process so the views of funeral service are presented for consideration.