Medical Evaluation and Follow-up

When a worker experiences an exposure incident,

the employer must make immediate confidential

medical evaluation and follow-up available to the

worker. This evaluation and follow-up must be:

made available at no cost to the worker and at a

reasonable time and place; performed by or under

the supervision of a licensed physician or other

licensed healthcare professional; and provided

according to the recommendations of the U.S.

Public Health Service (USPHS) current at the time

the procedures take place. In addition, laboratory

tests must be conducted by an accredited laboratory and also must be at no cost to the worker. A

worker who participates in post-exposure evaluation and follow-up may consent to have his or her

blood drawn for determination of a baseline infection status, but has the option to withhold consent

for HIV testing at that time. In this instance, the

employer must ensure that the worker's blood

sample is preserved for at least 90 days in case

the worker changes his or her mind about HIV

testing. 

Post-exposure prophylaxis for HIV, HBV, and HCV,

when medically indicated, must be offered to the

exposed worker according to the current recommendations of the U.S. Public Health Service. The

post-exposure follow-up must include counseling

the worker about the possible implications of the

exposure and his or her infection status, including

the results and interpretation of all tests and how

to protect personal contacts. The follow-up must

also include evaluation of reported illnesses that

may be related to the exposure.

Reporting an Exposure Incident

Exposure incidents should be reported immediately to the employer since they can lead to infection with hepatitis B virus (HBV), hepatitis C virus

(HCV), human immunodeficiency virus (HIV), or

other bloodborne pathogens. When a worker

reports an exposure incident right away, the

report permits the employer to arrange for immediate medical evaluation of the worker. Early

reporting is crucial for beginning immediate intervention to address possible infection of the worker and can also help the worker avoid spreading

bloodborne infections to others. Furthermore, the

employer is required to perform a timely evaluation of the circumstances surrounding the exposure incident to find ways of preventing such a

situation from occurring again. 

Reporting is also important because part of the

follow-up includes identifying the source individual, unless the employer can establish that identification is infeasible or prohibited by state or local

law, and determining the source’s HBV and HIV

infectivity status. If the status of the source individual is not already known, the employer is

required to test the source’s blood as soon as feasible, provided the source individual consents. If

the individual does not consent, the employer

must establish that legally required consent cannot be obtained. If state or local law allows testing

without the source individual’s consent, the

employer must test the individual’s blood, if it is

available. The results of these tests must be made

available to the exposed worker and the worker

must be informed of the laws and regulations

about disclosing the source’s identity and infectious status.

FactSheet

Bloodborne Pathogen Exposure Incidents 

OSHA’s Bloodborne Pathogens standard (29 CFR 1910.1030) requires employers to

make immediate confidential medical evaluation and follow-up available for workers

who have an exposure incident, such as a needlestick. An exposure incident is a 

specific eye, mouth, other mucous membrane, non-intact skin, or parenteral contact

with blood or other potentially infectious materials (OPIM), as defined in the standard

that results from the performance of a worker’s duties. 
This is one in a series of informational fact sheets highlighting OSHA programs, policies or 

standards. It does not impose any new compliance requirements. For a comprehensive list of 

compliance requirements of OSHA standards or regulations, refer to Title 29 of the Code of Federal

Regulations. This information will be made available to sensory-impaired individuals upon request.

The voice phone is (202) 693-1999; teletypewriter (TTY) number: (877) 889-5627.

Written Opinion

The employer must obtain and provide the 

worker with a copy of the evaluating healthcare

professional’s written opinion within 15 days of

completion of the evaluation. According to

OSHA’s standard, the written opinion should 

only include: whether hepatitis B vaccination was

recommended for the exposed worker; whether

or not the worker received the vaccination, and

that the healthcare provider informed the worker

of the results of the evaluation and any medical

conditions resulting from exposure to blood or

OPIM which require further evaluation or treatment.

Any findings other than these are not to be included

in the written report.

Additional Information

For more information, go to OSHA’s Bloodborne

Pathogens and Needlestick Prevention Safety and

Health Topics web page at: https://www.osha.gov/

SLTC/bloodbornepathogens/index.html.

To file a complaint by phone, report an emergency,

or get OSHA advice, assistance, or products, 

contact your nearest OSHA office under the “U.S.

Department of Labor” listing in your phone book, 

or call us toll-free at (800) 321-OSHA (6742). 

Occupational Safety

and Health Administration

www.osha.gov 1-800-321-6742

For assistance, contact us. We can help. It’s confidential.

DSG 1/2011