By Gary Evans, Medical Writer 

Despite demands for flexibility by infection control groups, the Occupational Safety and Health Administration (OSHA) is being urged by one of its more prominent former directors to adopt a tough standard that includes airborne transmission requirements to protect healthcare workers from COVID-19. 

OSHA is finalizing its Emergency Temporary Standard (ETS) to protect healthcare workers from COVID-19, and held an April 27, 2022 hearing before the brief comment period closed. 

A professor at George Washington University in the nation’s capital, David Michaels, PhD, was assistant secretary of OSHA from 2009 to 2017, making him the longest serving director in the agency's history.

While testifying at the OSHA hearing, Michaels leveled a broadside at the Centers for Disease Control and Prevention (CDC), essentially accusing the agency of initially downplaying the risk of airborne COVID-19 in favor of droplet spread. In May 2021, the CDC reported there were cases of airborne spread beyond six feet, and the World Health Organization eventually reversed its position as well.  

Saying “there is no longer debate over the importance of aerosol exposure,” Michaels urged OSHA to develop an evidence-based OSHA standard that formally recognizes “the primacy” of this route in order to protect workers from all respiratory pathogens.

”The final OSHA standard must be evidence-based and recognize the ease with which this airborne disease is transmitted.” Michaels said at the hearing. “It should require employers to follow the hierarchy of controls, including engineering controls, to provide clean indoor air, including ventilation, filtration, and/or application of germicidal, ultraviolet technology, respiratory protection programs requiring NIOSH-certified respirators, medical removal benefits, including paid leave, and enhanced recording and reporting cases.”

In announcing the plan for final rulemaking, OSHA showed a willingness to be more flexible without committing to a regulation that would change with future CDC revisions. 

“An OSHA regulation should allow health care facilities the flexibility to tailor their approach on infection prevention and control based on their risk assessment, rapidly changing evidence-based CDC guidance, supply availability and shortages, community transmission rates, and other factors that may change quickly and are specific sometimes to that facility or even that unit,” Lisa Sturm, MPH, CIC, FAPIC, said in testifying for the Association of Professionals in Infection Control and Epidemiology (APIC) at the hearing.

For more on this story, see the next issue of Hospital Infection Control & Prevention. 

Gary Evans, BA, MA, has written numerous articles on infectious disease threats to both patients and healthcare workers. These include stories on HIV, SARS, SARS-CoV-2, pandemic influenza, MERS, and Ebola. He has been honored for excellence in analytical reporting five times by the National Press Club in Washington, DC.