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'OSHA is back,' targets HCW infections, injuries
New standard in store for infectious disease?
Health care remains in the spotlight of an energized U.S. Occupational Safety and Health Administration (OSHA) as the agency explores new regulations related to infectious diseases and requirements for injury and illness prevention programs.
OSHA also announced that it will be increasing its average penalties for severe violations, signaling a tougher enforcement policy.
"OSHA is back," says Bill Borwegen, MPH, health and safety director of the Service Employees International Union (SEIU) in Washington, DC. "We weren't sure they had a pulse in the last eight years. They're back on the beat."
Employers will see an immediate impact from OSHA's increase in minimum and average penalties for violations, says Brad Hammock, Esq., workplace safety compliance practice group leader at Jackson Lewis LLP in the Washington DC region office.
"[Previously], if you violated five standards, the fine might be $1,500," he says. "Now, you could get a penalty of $2,500."
OSHA said the average penalty for a serious violation will increase from $1,000 to about $3,000 or $4,000. "It signals that the agency is going to look for any number of different ways to increase penalties," Hammock says. "They're making it clear that the penalty structure currently is not adequate to deter conduct and to get employers to address hazards."
OSHA is also supporting the Protect America's Workers Act (HR 2067), which would update the Occupational Safety and Health (OSH) Act to increase maximum penalties, strengthen whistleblower protections, and place public employers under OSHA enforcement. In the future, penalty maximums would rise with inflation. The House bill has 90 co-sponsors and the Senate bill (SB 1850) has 22 co-sponsors.
"[Public hospital employees] work under some of the most challenging working conditions, yet they have no OSHA coverage," says Borwegen. "The OSH Act needs to be modernized and that's what this legislation will do."
Future rule could include contact exposure
OSHA has shown particular interest in the hazards facing the health care workforce. In its spring regulatory agenda, and then in a subsequent Federal Register notice, OSHA expressed concern that workplace infectious disease hazards aren't being adequately tracked and that infection control measures, including hand hygiene and respiratory protection, aren't being adequately followed.
"Workplace-acquired infections are a persistent problem and there are also increasing levels of drug-resistant microorganisms in healthcare settings. Moreover, most current infection control efforts are intended primarily for patient protection and not for worker protection," OSHA said in its regulatory agenda. "OSHA has developed a request for information on infectious diseases to better assess the extent of the problem and better understand ways to protect healthcare workers from infectious diseases."
OSHA is considering diverging from the model set by California, which has a new Aerosol Transmissible Disease standard, with a more comprehensive approach that would cover infectious diseases spread through contact exposure.
Yet OSHA is also asking for comments about whether guidelines or other non-regulatory measures could adequately protect workers.
A standard on infectious diseases could spur new resources for infection control and employee health, says Borwegen. It could work in tandem, not in conflict, with guidelines from the Centers for Disease Control and Prevention, he says. "We wouldn't want any contradiction between CDC guidelines and an OSHA regulation," he says. "We've never had that problem in the past. That's kind of a red herring."
Meanwhile, OSHA has announced its intention to revive work on a rule requiring employers to have an injury and illness prevention program. It would include a process for identification and control of hazards, training and program evaluation, and would outline the roles of managers and employees.
The rule would essentially require proactive measures to address hazards rather than responding to injuries. "We are asking employers to 'find and fix' the hazards in their workplaces," Assistant Secretary of Labor for OSHA David Michaels said in a statement.
Typically, it has taken many years for OSHA to promulgate a new rule. "I would like to think it's a new day at OSHA," says Borwegen. "[This is] an OSHA that's interested in moving quickly."
[Editor's note: The Federal Register notice on OSHA's request for information about an infectious disease standard is available at www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=FEDERAL_REGISTER&p_id=21497. OSHA is accepting comments through August 4 at www.regulations.gov.]