TWI BULLETIN NO. 6

Temporary Worker Initiative

Bloodborne Pathogens 

This is part of a series of guidance documents developed under the 

Occupational Safety and Health Administration’s (OSHA’s) Temporary Worker 

Initiative (TWI). This Initiative focuses on compliance with safety and health 

requirements when temporary workers are employed under the joint 

employment of a staffing agency and a host employer.

Temporary workers are entitled to the same 

protections under the Occupational Safety and 

Health Act of 1970 (the OSH Act) as all other 

covered workers. When a staffing agency supplies 

temporary workers to a business, typically, the 

staffing agency and the staffing agency’s client 

(commonly referred to as the host employer) are 

considered joint employers of those workers. Both 

employers are responsible for determining the 

conditions of employment and complying with 

the law. In these joint employment situations, 

questions regarding how each employer can fulfill 

their duty to comply with OSHA standards are 

common. This bulletin addresses what both the 

staffing agency and the host employer can do to 

ensure that temporary workers are protected from 

exposure to bloodborne pathogens in accordance 

with OSHA standard 29 CFR 1910.1030 — 

Bloodborne Pathogens (the standard).

Bloodborne pathogens are microorganisms in 

human blood and other bodily fluids that can 

cause infectious diseases in humans. These 

pathogens include, but are not limited to, 

the hepatitis B virus (HBV), hepatitis C virus 

(HCV), and human immunodeficiency virus 

(HIV). All occupational exposure to blood or 

other potentially infectious materials1 (OPIM), 

including needlesticks and other sharps-related 

injuries, places workers at risk for infection from 

bloodborne pathogens. Temporary workers may 

be at risk for exposure to bloodborne pathogens 

in many professions including, but not limited to, 

nursing and other healthcare work, housekeeping 

in some industries, and emergency response.

Workers with reasonably anticipated occupational 

exposure2 to bloodborne pathogens must 

be afforded protections in accordance with 

the standard, 29 CFR 1910.1030(c)(1), under 

the employer’s written exposure control plan 

including but not limited to the following:

1. The standard at 29 CFR 1910.1030(b) defines “blood” to mean 

human blood, human blood components, and products made from 

human blood. Other potentially infectious materials (OPIM) means: 

(1) The following human body fluids: semen, vaginal secretions, 

cerebrospinal fluid, synovial fluid, pleural fluid, pericardial fluid, 

peritoneal fluid, amniotic fluid, saliva in dental procedures, any 

body fluid that is visibly contaminated with blood, and all body 

fluids in situations where it is difficult or impossible to differentiate 

between body fluids; (2) Any unfixed tissue or organ (other than 

intact skin) from a human (living or dead); and (3) HIV-containing 

cell or tissue cultures, organ cultures, and HIV- or HBV-containing 

culture medium or other solutions; and blood, organs, or other 

tissues from experimental animals infected with HIV or HBV.

2. Occupational exposure means reasonably anticipated skin, eye, 

mucous membrane, or parenteral (outside the intestines) contact 

with blood or other potentially infectious materials that may result 

from the performance of an employee’s duties.
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• Exposure determination;

• Universal precautions, engineering and work 

practice controls, personal protective equipment, 

and housekeeping;

• Procedures for HIV and HBV research laboratories 

and production facilities if applicable;

• Hepatitis B vaccination and post-exposure 

follow-up;

• Procedures for evaluating circumstances 

surrounding an exposure incident;

• Communication of hazards including information 

and training; and

• Recordkeeping, including a sharps injury log 

if applicable.

As joint employers, both the host and the staffing 

agency are responsible for ensuring that the 

temporary employee is properly protected against 

bloodborne pathogens. However, the employers may 

decide that a division of the compliance responsibility 

may be appropriate. In doing so, the staffing 

agency and host employer should jointly review 

the task assignments and job hazards to include 

temporary workers in an exposure control plan. 

The details of the protections to be provided can 

be clearly established in the contract language 

between the employers. While the employers may 

agree to divide responsibilities, neither employer may 

avoid its ultimate responsibilities under the OSH Act 

by shifting responsibilities to the other employer. 

Host Employer Responsibilities

Generally, the host employer has the primary 

responsibility for developing and implementing 

a written exposure control plan at the worksite 

because the host employer creates and controls the 

work processes at the facility and is most familiar 

with tasks having the potential for occupational 

exposure to bloodborne pathogens. The host 

employer is also typically responsible for providing 

site-specific bloodborne pathogens training and 

personal protective equipment, which should be 

equivalent to that given to the host’s own employees 

in the same job classifications. The host employer 

also has the primary responsibility for controlling 

hazardous conditions at its worksite, including 

ensuring that engineering and work practice controls, 

such as sharp injury protections, are in place. 

In addition, the employer who has day-to-day 

supervision over the temporary workers, typically 

the host employer, is required to maintain a 

log of occupational injuries and illnesses under 

29 CFR 19043 and to record injuries and illnesses 

of temporary workers on that log. The Bloodborne 

Pathogens standard requires that this employer must 

also maintain a sharps injury log for the recording 

of percutaneous (through the skin) injuries from 

contaminated sharps and to record such injuries 

occurring to temporary workers on that log. 

The host employer must communicate and 

coordinate with the staffing agency to ensure 

compliance with the standard’s provisions, 

particularly regarding post-exposure evaluation 

and follow-up. It is also the host employer’s 

obligation to take reasonable measures to ensure 

that the staffing agency has complied with its 

responsibilities for hepatitis B vaccination, postexposure evaluation and follow-up, medical and 

training records retention, and generic training. 

Staffing Agency Responsibilities

The staffing agency whose employees have 

reasonably anticipated occupational exposure 

to blood or OPIM is responsible for providing 

generic bloodborne pathogen information and 

training, ensuring that the temporary workers are 

provided with the required vaccinations and followup, providing proper post-exposure evaluation 

and follow-up after an exposure incident, and 

retaining applicable medical and training records in 

accordance with 1910.1030(h). The staffing agency 

is also responsible for (1) violations occurring at the 

workplace about which the staffing agency actually 

knew and where the staffing agency failed to take 

reasonable steps to have the host employer correct 

the violation and (2) pervasive serious violations 

occurring at the workplace about which the staffing 

agency could have known with the exercise 

of reasonable diligence. See OSHA Directive, 

CPL 02-02-069, Enforcement Procedures for the 

Occupational Exposure to Bloodborne Pathogens, 

paragraph XI.B, Personnel Services. 

3. www.osha.gov/temp_workers/OSHA_TWI_Bulletin.pdf
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Example Scenario*

An urban out-patient surgical center, Eastern SC, Inc. (ESC) needs housekeeping workers to 

clean (e.g., change linens, empty trash) and resupply surgical suites and recovery rooms during 

an exceptionally busy period of the year. The company contracts with a personnel service, 

HKMed Staffing, which employs medical care staff and service employees. These employees 

are assigned to work at hospitals and other healthcare facilities to perform housekeeping duties. 

Compliance with safety and health requirements is mentioned in HKMed’s contract with ESC, 

including coverage for the temporary workers under both ESC’s and HKMed’s bloodborne 

pathogens exposure control plans. The contract states that HKMed will provide temporary 

workers who have hepatitis B vaccinations and basic bloodborne pathogens training and that ESC 

will provide site-specific bloodborne pathogens training, work practice and engineering controls, 

and personal protective equipment to those temporary workers. 

HKMed assigns five temporary workers to ESC. Before sending the workers to the ESC worksite, 

the staffing agency plays a generic bloodborne pathogens training video for them that includes 

general information on hazards associated with blood and OPIM, information on the hepatitis B 

vaccinations, and what to do should an exposure incident occur. A question and answer period 

is also included in the training. In addition, HKMed ensures that each worker is offered or has 

had the hepatitis B vaccination series. 

At the worksite, the ESC human resources representative assigns the temporary workers to 

the surgical and recovery areas to clean the rooms, including changing linen and restocking. 

The workers are provided with limited site-specific training. They are not provided with an 

explanation of ESC’s exposure control plan, but are shown where to access housekeeping and 

general medical supplies, where to access regulated waste containers for waste containing 

visible blood, and where the sharps containers are located for the disposal of used needles. 

They are instructed not to handle any sharps containers and to notify one of the nurses if a 

sharps container is full. Utility gloves and appropriate disinfecting and cleaning supplies are 

made available to the workers in the supply area. 

A temporary worker mentions to the ESC human resources representative that oftentimes the 

sharps containers are full and that used sharps are sometimes found on top of the container and 

around patient areas. The ESC human resources representative tells the worker that the center 

is understaffed and she will look into it. The worker also notifies his HKMed supervisor of this 

situation. HKMed tells the worker to be careful. A week after the notification, one of the temporary 

workers experiences a needlestick while placing a used needle found in dirty bed linens into an 

overflowing sharps container. ESC immediately recorded the incident on the needlestick injury 

log and notified HKMed. HKMed sent the worker for post-exposure evaluation and follow-up. 

Analysis

Eastern SC and HKMed have a joint responsibility to ensure that the temporary workers are 

protected from occupational exposure to blood and OPIM. Since ESC controls the worksite, it is 

responsible for controlling occupational exposure to blood and OPIM by considering and using 

safer medical devices, ensuring sharps are properly disposed, and ensuring that used sharps 

containers are properly maintained. ESC also must provide site-specific bloodborne pathogens 

training, which in this scenario was inadequate. ESC may be subject to OSHA citations under 

the methods of compliance, housekeeping, and information and training sections of the 
standard. HKMed also has a responsibility to take reasonable steps to ensure the protection of 

its workers, particularly after being notified about problems with the disposal of sharps. HKMed 

should have contacted ESC to discuss its concerns and remedy the situation. Thus, HKMed may 

also be subject to OSHA citations under the housekeeping section of the standard. 

Both employers took some appropriate actions with respect to the needlestick injury. Prior 

to starting the work, HKMed ensured that the workers were vaccinated for hepatitis B and 

provided generic bloodborne pathogens training. Also, HKMed ensured that the injured 

worker was immediately provided post-exposure evaluation and follow-up. In addition, ESC 

appropriately recorded the incident on the needlestick injury log.

*The company names used in this scenario are fictitious. Any resemblance to real companies is entirely coincidental.

State Plans

Twenty-eight states and U.S. territories have their 

own OSHA-approved occupational safety and health 

programs called State Plans. State Plans have and 

enforce their own occupational safety and health 

standards that are required to be at least as effective 

as OSHA’s, but may have different or additional 

requirements. A list of the State Plans and more 

information is available at www.osha.gov/dcsp/osp. 

How Can OSHA Help?

Workers have a right to a safe workplace. If you 

think your job is unsafe or you have questions, 

contact OSHA at 1-800-321-OSHA (6742). It’s 

confidential. We can help. For other valuable 

worker protection information, such as Workers’ 

Rights, Employer Responsibilities and other 

services OSHA offers, visit OSHA’s Workers’ page 

at www.osha.gov/workers.

For information on Temporary Workers visit 

OSHA’s Temporary Workers’ page at www.osha.gov/

temp_workers.

The OSH Act prohibits employers from retaliating 

against their employees for exercising their rights 

under the OSH Act. These rights include raising 

a workplace health and safety concern with the 

employer, reporting an injury or illness, filing an 

OSHA complaint, and participating in an inspection 

or talking to an inspector. If workers have been 

retaliated or discriminated against for exercising 

their rights, they must file a complaint with OSHA 

within 30 days of the alleged adverse action to 

preserve their rights under section 11(c). For more 

information, please visit www.whistleblowers.gov.

OSHA also provides help to employers. OSHA’s 

On-site Consultation Program offers free and 

confidential occupational safety and health 

services to small and medium-sized businesses in 

all states and several territories, with priority given 

to high-hazard worksites. On-site Consultation 

services are separate from enforcement and do not 

result in penalties or citations. Consultants from 

state agencies or universities work with employers 

to identify workplace hazards, provide advice 

on compliance with OSHA standards, and assist 

in establishing and improving safety and health 

management systems. To locate the OSHA On-site 

Consultation Program nearest you, call 1-800-321-

6742 (OSHA) or visit www.osha.gov/consultation.

Disclaimer: This bulletin is not a standard or regulation, and it creates no new legal obligations. It contains recommendations as well as 

descriptions of mandatory safety and health standards. The recommendations are advisory in nature, informational in content, and are 

intended to assist employers in providing a safe and healthful workplace. The Occupational Safety and Health Act requires employers to 

comply with safety and health standards and regulations promulgated by OSHA or by a state with an OSHA-approved state plan. In addition, 

the OSH Act’s General Duty Clause, Section 5(a)(1), requires employers to provide their employees with a workplace free from recognized 

hazards likely to cause death or serious physical harm.

For more information

Occupational

Safety and Health

Administration

www.osha.gov (800) 321-OSHA (6742) U.S. Department of Labor

OSHA 3888-09 2016