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Gary Evans writes Hospital Infection Control & Prevention (HIC), Hospital Employee Health (HEH) and contributes to IRB Advisor (IRB). As senior writer at AHC, Evans has written numerous articles on infectious disease threats to both patients and health care workers, including pandemic influenza, MERS and Ebola. He has been honored for excellence in analytical reporting five times by the National Press Club in Washington, DC.
By Michele Cohen Marill, Editor, Hospital Employee Health
Infection control measures -- including hazard identification and exposure control -- would become mandatory under a proposed infectious diseases rule by the Occupational Safety and Health Administration (OSHA).
OSHA has been working on the rule for years, so the timing with the first cases of Ebola in the U.S. is coincidental. But ongoing Ebola events provide a compelling backdrop for OSHA action, particularly the recent infection of two nurses in Dallas and the subsequent decision by the Centers for Disease Control and Prevention to increase the “margin of safety” with enhanced infection control for health care workers.
“Workers currently face a number of infectious diseases, and there are always new threats over the horizon – MERS, Avian Flu, and, of course, Ebola,” an OSHA spokesperson told HEH. “The infectious disease standard would require employers to have a plan to protect their employees from any infectious disease, rather than going on a disease-by-disease basis.”
The 38-page draft entitled “OSHA’s Infectious Diseases Regulatory Framework” was recently posted on a government regulatory site and has not yet been published for formal review and comment. Employee health professionals expressed concern with provisions that involve significant documentation and policy writing. Parts of the proposed regulation also could overlap with existing state and local health laws, requirements from accrediting bodies and even other OSHA standards, says Dee Tyler, RN, COHN-S, FAAOHN, executive president of the Association of Occupational Health Professionals in Healthcare (AOHP).
“We can make things so complex that healthcare providers and organizations find it impossible to comply with all the regulations and become distracted from their primary mission,” she says.
Likewise infection preventionists may also have concerns about issues of policy-writing and documentation, particularly since they recently sounded the alarm about being overwhelmed by Ebola training demands. CDC guidelines are recommendations and are not enforceable as regulations. Currently, only California hospitals face enforcement action if they don’t follow infection control guidelines. The national OSHA draft standard is modeled in part on the California Aerosol Transmissible Disease standard -- which covers diseases that are spread by the droplet and airborne routes -- and includes some existing requirements in the OSHA Bloodborne Pathogen Standard.
The draft OSHA infectious disease standard would require hospitals and other health care employers to: