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This award-winning blog supplements the articles in Hospital Infection Control & Prevention.

Paper tiger no more: OSHA hits nursing homes, physician offices for lax infection control

Some health care employers are failing to take even the most basic steps to protect against bloodborne pathogen exposures, and the U.S. Occupational Safety and Health Administration is beginning to take notice.

In 85 inspections last year of doctors’ offices, OSHA issued more than $235,000 in fines for violations of the Bloodborne Pathogen Standard. Hospitals are cited more often for violations of that standard than for any other violation. And OSHA has targeted bloodborne pathogen compliance in its National Emphasis Program on nursing homes. In 2012, 47 nursing homes received $132,000 in fines.

“We really are looking at these issues and we will cite people who are not complying,” says Dionne Williams, MPH, director of OSHA’s Office of Health Enforcement.

The number of OSHA inspections is small compared to the scope of the health care workforce. There are about 5,700 hospitals, 16,000 nursing homes and about 50,000 multi-physician offices in the United States. But when inspectors target health care, they often find that employers fail to adequately train employees or update their exposure control plans. In some cases, they aren’t even providing safety-engineered devices.

The Pittsburgh area office of OSHA conducted 10 special inspections in a year-long local emphasis program on health care that ended in September 2012. Inspectors cited a hospital and an allergy clinic for failing to offer the hepatitis B vaccine to all employees at risk. An ambulatory surgery center and a doctor’s office weren’t using safety-engineered devices. Sharps containers were overfilled or unsafe, OSHA said.

“It’s very difficult to believe that anyone running a hospital or a clinic would not have these [bloodborne pathogen] rules well-documented and have familiarity with them,” says Janine Jagger, PhD, MPH, director of the International Health Care Worker Safety Center at the University of Virginia in Charlottesville. “I think it’s just a question of doing the easiest thing if no one is looking.”

Jagger and other sharps safety experts have long expressed concern about compliance with the Bloodborne Pathogen Standard in non-hospital settings. “OSHA is well aware that there are risks that are not being properly addressed in doctors’ offices and non-hospital facilities, and they’re turning their attention in that direction,” she says.

--Michele Marill, Hospital Employee Health