Cal/OSHA Adopts New Standard for Airborne Diseases

May 28, 2009 – In an historic action on May 21, 2009, flanked by a room full of unionized workers – including representatives from the IAFF and California Professional Firefighters (CPF) – the California Occupational Safety and Health Standards Board approved the adoption of a new Cal/OSHA Aerosol Transmissible Disease (ATD) Standard by a unanimous 6-0 vote.

“I congratulate our California members, and all within organized labor, for working with Cal/OSHA to implement this first-in-the nation workplace standard designed to protect workers from airborne transmitted diseases,” says IAFF General President Harold Schaitberger. “The IAFF is committed to working to address this important worker protection issue throughout North America.

The IAFF has joined a number of other labor unions and the AFL-CIO to petition the Occupational Safety and Health Administration (OSHA) to address this issue, and will continue efforts with the Centers for Disease Control and Prevention (CDC) and National Institute for Occupational Safety and Health (NIOSH) to scientifically address the proper respirators needed to protect against exposure to aerosolized infectious diseases.

Joining other California unions, CPF testified in support of the legislation, following the IAFF’s position recommending that Cal/OSHA should only allow no less than a P100 filtering facepiece respirator for protection against diseases. In addition, CPF and the IAFF stated to Cal/OSHA that until it is scientifically proven that a lower level of respirator protective equipment works, such as a N95 respirator, a minimum a P100 should be used.

CPF President Lou Paulson says, “California has come a long way in protecting IAFF members who provide emergency medical care, but we still need to aggressively address these issues, especially as they pertain to respiratory protection.”

In adopting this standard, Cal/OSHA recognizes that workers providing emergency medical response, including paramedics, fire fighters and other emergency medical and medical transport personnel, provide critical care to people in field situations where there may be limited options for controlling airborne infectious disease exposures. This care may include procedures that can generate infectious aerosols and expose employees to the risk of contracting an aerosol transmissible disease (ATD).

The new ATD standard now establishes requirements to reduce infectious disease risk to these employees. It also contains provisions to ensure that emergency medical personnel are able to receive timely information and follow up if they have treated or transported a patient who was subsequently determined to have a reportable ATD. Although certain engineering controls, such as airborne infection isolation rooms, are not available to protect emergency medical personnel, the standard requires that employers provide alternate means of protecting emergency response employees. Specifically, the standard requires the employer to:

• Develop a written ATD exposure control plan that addresses control measures for aerosol transmissible diseases and that identifies individuals responsible for implementing the plan.

• Reduce exposures by engineering controls, work practices and personal protective equipment.

• Establish procedures for the early identification and appropriate placement of patients requiring airborne infection isolation.

• Establish communications procedures within the organization and facilities to and from which patients are transported that include information regarding the infectious disease status of patients who will be or have been treated or transported and notification to employees and other employers whose employees had exposure to a reportable case.

• Provide respirators to employees who are potentially exposed to suspect or confirmed cases of diseases that require airborne infection isolation. When employees perform aerosol generating procedures on suspect or confirmed cases, such as intubation, they should be provided with a powered air purifying respirator, unless it would interfere with the completion of the task.

• Implement control measures for employees who operate, use or maintain vehicles that transport people who with ATD cases or suspected cases, including feasible barriers and air handling systems, source control measures (such as providing a mask or tissues) and hand hygiene materials to persons who are coughing, if feasible. In addition, a respirator cannot be used if it would interfere in the safe operation of a vehicle, in which case, the employer must provide other control methods.

• Implement procedures for decontamination of vehicles and decontamination or disposal of equipment.

• Provide medical surveillance for employees who have occupational exposure, including annual TB tests and follow-up for TB conversions, vaccinations of susceptible health care workers for mumps, measles and rubella (MMR), varicella-zoster, tetanus, diphtheria and acellular pertussis (Tdap) and provide seasonal influenza vaccine to all employees. Employees may decline vaccination. The standard also requires follow up of exposure incidents (reportable ATDs), including continuation of pay for a period during which an employee is not sick but a physician or other licensed health care professional recommends removal from the workplace because the employee may be contagious (unless alternate work is available).

• Provide initial and annual training on the ATD exposure control plan.

• Keep records, including medical records, records of testing of ventilation systems and other engineering controls, training records and records of exposure incidents.

For more information about the Cal/OSHA standard, click here.