OSHA has published a hazard information

bulletin (HIB) to provide guidance to people who

reside in high or moderate risk areas in the United

States and who are exposed to ticks during the course

of their work and thus at risk of contracting Lyme

disease.* Examples of outdoor work which may be

associated with increased risk of exposure to infected

ticks include: construction work, landscaping,

forestry, brush clearing, land surveying, farming,

railroad work, oil field work, utility line work,

and park/wildlife management.

The Centers for Disease Control and Prevention (CDC) has developed a national Lyme disease

risk map1

 in which CDC identified areas of the U.S.

as minimal or no risk, low risk, moderate risk, or

high risk for predicted Lyme disease. Areas at high

or moderate risk include many counties in the Northeast U.S., some areas around the Great Lakes, and

an area in Northern California. It is important

that state and local health department authorities be

consulted to determine risk in any given area, since

risk can vary even within a county, and perhaps from

year to year.

Lyme disease is caused by Borrelia burgdorferi,

a bacterium carried in the gut of certain ticks. When

these infected ticks attach to the human body (often

in armpits, groin, scalp, or other hairy, hidden body

areas), they slowly feed, and within 36-48 hours they

may transmit B. burgdorferi to their human host.

Young ticks are especially abundant and are seeking

hosts in late spring and early summer, although adult

ticks can transmit infection as well.

Note: This map demonstrates an approximate distribution of

predicted Lyme disease risk in the United States. The true

relative risk in any given county compared with other

counties might differ from that shown here and might change

from year to year.1

High risk

Moderate risk

Low risk

Minimal or no risk

National Lyme disease risk map with four

categories of risk

Although a majority of people with Lyme disease develop a “bulls-eye” rash, 20-40% of persons

who have the disease do not have a rash. Other signs

and symptoms may be non-specific and similar to

flu symptoms (e.g., fever, lymph node swelling, neck

stiffness, generalized fatigue, headaches, migrating

joint aches, or muscle aches). Diagnosis is based on

a history of known exposure and development of

clinical signs and symptoms, with blood testing

providing valuable supportive information. Most

cases of Lyme disease can be successfully treated

with antibiotics. It is very important that Lyme disease be diagnosed and treated with antibiotics, since

untreated Lyme disease may result in symptoms (i.e.,

arthritis, muscle pain, heart disease, brain and nerve

disorders) that are severe, chronic, and disabling.

This fact sheet is informational in content and advisory in nature.

It is not a new standard or regulation and creates no legal obligation.

Lyme Disease

facts

U.S. Department of Labor

Occupational Safety and Health Adminsitration

* See OSHA HIB 00-04 online at www.osha.gov or by

calling your nearest OSHA office listed in the blue pages of

your telepone directory.

1 “Recommendations for the Use of Lyme Disease Vaccine;

Recommendations of the Advisory Committee on Immunization

Practices (ACIP).” MMWR 6/4/1999, 48 (RR-7). www.cdc.gov.
The Directorate of Technical Support issues Hazard Information Bulletins (HIBs) in accordance with OSHA Instruction CPL 2.65 to provide

relevant information regarding unrecognized or misunderstood health and safety hazards, as well as potential hazards associated with

particular materials, devices, techniques, and engineering controls. An HIB is not a new standard or regulation, and it creates no legal

obligations. It is advisory in nature, informational in content, and is intended for use by employers seeking to provide a safe and healthful

workplace. The Occupational Safety and Health Act requires employers to comply with hazard-specific safety and health standards. In

addition, employers must provide their employees with a workplace free from recognized hazards likely to cause death or serious physical

harm under Section 5(a)(1), the General Duty Clause of the Act. Employers can be cited for violating the General Duty Clause if there is a

recognized hazard and they do not take steps to prevent or abate the hazard. However, failure to implement HIB recommendations is not, in

itself, a violation of the General Duty Clause. Citations can only be based on standards, regulations, and the General Duty Clause.

Prevention of Lyme Disease

First line of defense is decreasing the probability of tick bites.1

 Ticks can be vectors of other

infections, in addition to Lyme disease.

- Avoidance of tick habitat (brushy, overgrown

grassy, and woody areas) particularly in spring

and early summer when young ticks feed.

- Removal of leaves, tall grass, and brush from

areas around work areas or residential areas to

decrease tick as well as host (deer and rodent)

habitat.

- Application of tick-toxic chemicals to surrounding work or residential areas in accordance

with federal, state, and local regulations and

community standards.

Personal Protection

- Wearing light-colored clothing (to more easily see

ticks).

- Wearing long-sleeved shirts, tucking pant legs into

socks or boots (delays ticks from reaching skin so

they can be more easily found before attaching).

- Wearing high boots or closed shoes covering

entire foot.

- Wearing a hat.

- Using appropriate insect repellants on non-facial

skin and permethrin on clothes (kills ticks) in

accordance with Environmental Protection

Agency guidelines.

- Showering and washing/drying clothes at high

temperature after outdoor exposure.

- Doing a careful body check for ticks, prompt

removal with tweezers and skin cleansing with

antiseptic.

.

Workers at risk should be advised of the signs

and symptoms of Lyme disease, as well as the

primary and secondary preventive measures for this

disease. Those who are at increased risk for Lyme

disease should obtain medical advice regarding the

applicability of the Lyme disease vaccine; those who

have symptoms of suspected tick-borne infection

should seek medical attention early. More detailed

information regarding various aspects of Lyme

disease prevention can be found on the CDC web

site (www.cdc.gov).