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OSHA: Infectious disease standard still on table
Would be closely aligned with CDC
Hospitals aren't doing enough to protect their employees from infectious diseases, U.S. Occupational Safety and Health (OSHA) administrator David Michaels, PhD, MD, told employee health professionals in a recent Webinar for members of the Association of Occupational Health Professionals in Healthcare (AOHP).
"Healthcare-acquired infections are a persistent problem. We believe the increasing levels of drug-resistant microorganisms in health care settings really tell us we should do something much more comprehensive than we've done now," he said. "Most current infection control efforts are intended primarily for patient protection and there really isn't enough done on worker protection."
OSHA plans to issue a regulation patterned after the Bloodborne Pathogen Standard that would address diseases that are spread by airborne, droplet, and contact transmission, Michaels said. He touted the success of the Bloodborne Pathogen Standard, which received a positive response in comments as part of a recent regulatory review.
"The evidence is pretty clear. This standard has contributed to the prevention of thousands of cases of hepatitis B and of HIV in health care workplaces," he said.
Although he didn't directly address concerns about an infectious diseases standard, Michaels seemed to refer to statements by infection control practitioners that a standard isn't necessary and potentially would conflict with existing and future public health guidance. "We're looking to do this in a way that closely aligns us with the overall approach to infection control used in existing CDC [Centers for Disease Control and Prevention] guidance and industry standards," he said.
Seeking fundamental change
Overall, Michaels said OSHA has "a commonsense agenda," with an emphasis on injury prevention rather than creating many new standards. In late spring or early summer, OSHA is expected to release a draft of an Injury and Illness Prevention Program standard that would require employers to conduct hazard assessments and take action to address the hazards.
"We're trying to move toward a fundamental change in the way many employers think about safety and health," he said. "Instead of waiting for a government inspector to come or [for] a workplace injury or illness or fatality...this regulation would require all employers to do what many, many employers do now, which is to set up a process to find and fix the hazards they have."
Michaels urged employers not to give employees rewards for days or weeks without injuries. Even a pizza party could discourage employees from reporting injuries which is contrary to the goal of ferreting out hazards, he said.
"The minor injury or what's sometimes called a near-miss [is a] predictor of more serious injuries, but these incentive programs stop people from reporting those less severe injuries so the prevention never takes place," he said.
Michaels also vowed to use the general duty clause of the Occupational Safety and Health Act, which requires employers to keep their workplace free of hazards that can cause serious injury. He noted that in January, OSHA cited a psychiatric hospital in Bangor, ME, for failing to reduce the hazard of workplace violence. "We found at least 115 instances between 2008 and 2010 in which employees at the psychiatric hospital or the clinic there were assaulted on the job by a violent patient," he said.
OSHA also cited Danbury (CT) Hospital for failing to address workplace violence. (See HEH, October 2010, p.109.)
"Workplace violence is like any other hazard. We can predict it, we can predict where people are going to be hurt, and there are ways to reduce risk," he said. "We're not in rulemaking [for a standard in this area], but we certainly take this very seriously. We will issue citations if we see workplace violence that should have been prevented."