Following up on the discussion in our last issue of the Healthcare Update, this month we are examining one of the most rigorous and demanding areas of OSHA compliance – failure to meet the information and training requirements of the Bloodborne Pathogens Standard (BBP).

The standard states that the employer "shall train each employee with occupational exposure in accordance with the requirements of this section… [and] institute a training program and ensure employee participation in the program." The training required under the standard is to be performed both at the time of initial assignment to tasks where occupational exposure may take place, and annually thereafter. Employers are also required to provide additional training when changes such as a modification of tasks or procedures, or the implementation of new tasks or procedures, will affect the employee's occupational exposure.

Detailed Training Required

The elements of the BBP training standard are relatively burdensome and include explanations of all the following:

  • the epidemiology and symptoms of bloodborne diseases;
  • the modes of transmission of bloodborne pathogens;
  • the appropriate methods for recognizing tasks and other activities that may involve exposure to blood and other potentially infectious materials;
  • the use and limitations of methods that will prevent or reduce exposure including appropriate engineering controls, work practices, and personal protective equipment;
  • the types, proper use, location, removal, handling, decontamination and disposal of personal protective equipment;
  • the basis for selection of personal protective equipment;
  • the hepatitis B vaccine, including information on its efficacy, safety, method of administration, the benefits of being vaccinated, and that the vaccine and vaccination will be offered free of charge;
  • the appropriate actions to take and persons to contact in an emergency involving blood or other potentially infectious materials;
  • the procedure to follow if an exposure incident occurs, including the method of reporting the incident and the medical follow-up that will be made available;
  • the post-exposure evaluation and follow-up that the employer is required to provide for the employee following an exposure incident; and
  • the signs, labels and color coding required by OSHA.

The Legal Pitfalls

Keeping current with BBP information and training requirements can be one of the most difficult tasks you face as an employer in the healthcare industry, where advances in technology and medical procedures requires constant re-evaluation of BBP procedures and related training. The level of detail required in the training and staff turnover add to the challenge of staying in compliance. And this year, OSHA has a keen eye focused on the healthcare industry as well.

To make things more difficult, you can be cited under the standard for failure to train even if you miss just one employee in training or retraining. OSHA may also cite employers individually for each instance of a failure to train, although this is rare unless the employer's conduct has been particularly egregious.

These special challenges require appropriate resources to ensure that a systematic program is in place for training and retraining on the BBP standard. In a larger facility, this usually means identifying someone with full-time responsibility for the program. In smaller settings, such as a doctor's office, you should create a team system of audits and checks. Compliance can quickly fall behind if the person in charge of the program is out sick, on vacation or otherwise preoccupied with a project. Assigning the responsibility to detail-oriented, trusted staff is critical. And don't hesitate to call in reinforcements from the outside! If you need an expert or consultant to get your program started, get back on track, or just monitor it from time to time, it's usually an investment worth making.

The cost to organize a program focused on BBP training compliance is relatively small compared to the cost of significant OSHA citations that have the potential to become repeat citations in the future (which can be for another five years up to a cost of $70,000.00 each).