Document ID: OSHA-2010-0003-0227
Agency: osha
Document Type: Notice
Title: Infectious Diseases
Posted Date: 2011-07-05T04:00Z

[Federal Register: July 5, 2011 (Volume 76, Number 128)]
[Proposed Rules]               
[Page 39041-39043]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr05jy11-26]                         

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DEPARTMENT OF LABOR

Occupational Safety and Health Administration

29 CFR Part 1910

RIN 1218-AC46

 
Infectious Diseases

AGENCY: Occupational Safety and Health Administration (OSHA), Labor.

ACTION: Notice of stakeholder meetings.

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SUMMARY: OSHA invites interested parties to participate in informal 
stakeholder meetings concerning occupational exposure to infectious 
diseases. OSHA plans to use the information gathered at these meetings 
to explore the possible development of a proposed rule to protect 
workers from occupational exposure to infectious agents in settings, 
either where workers provide direct patient care or where workers 
perform tasks other than direct patient care that also have 
occupational exposure. These other work tasks include: Providing 
patient support services (e.g., housekeeping, facility maintenance); 
handling, transporting, receiving or processing infectious items or 
wastes (e.g., transporting medical specimens, disposing of medical 
waste); conducting autopsies or performing mortuary services; and 
performing tasks in laboratories.

DATES: Dates and locations for the stakeholder meetings are:
    July 29, 2011, 9 a.m.-noon in Washington, DC.
    July 29, 2011, 1:30 p.m.-4:30 p.m. in Washington, DC.
    The deadline for confirmed registration at the meeting is: July 22, 
2011. However, if space remains after this deadline, OSHA may accept 
additional participants until the meetings are full. Those who submit 
their registration after July 22, 2011 may not receive confirmation of 
their attendance from OSHA.

ADDRESSES: 
    Registration: Submit your notice of intent to participate in a 
stakeholder meeting through one of the methods below. Specify which 
meeting (morning or afternoon) you would like to attend.
    Electronic: Register at: https://www2.ergweb.com/projects/
conferences/osha/register-osha-stakeholder.htm (follow the instructions 
online).
    Facsimile: Fax your request to: (781) 674-7200, and label it 
``Attention: OSHA Infectious Diseases Stakeholder Meeting 
Registration.''
    Regular mail, express delivery, hand (courier) delivery, and 
messenger service: Send your request to: OSHA Infectious Diseases 
Stakeholder Meeting Registration, Attention: Thomas Nerad, OSHA, Room 
N-3718, 200 Constitution Avenue, NW., Washington, DC 20210.
    Meetings: The July 29, 2011 meetings will be held in the Francis 
Perkins Building, Room N-4437 at 200 Constitution Avenue, NW., 
Washington, DC 20210.

FOR FURTHER INFORMATION CONTACT: Information regarding this notice is 
available from the following sources:
    Press inquiries: Contact Frank Meilinger, Acting Director, OSHA 
Office of Communications, Room N-3647, U.S. Department of Labor, 200 
Constitution Avenue, NW., Washington, DC 20210; telephone: (202) 693-
1999.
    General and technical information: Contact Andrew Levinson, 
Director, Office of Biological Hazards, OSHA Directorate of Standards 
and Guidance, Room N-3718, U.S. Department of Labor, 200 Constitution 
Avenue, NW., Washington, DC 20210; telephone: (202) 693-2048.
    Copies of this Federal Register notice: Electronic copies are 
available at http://www.regulations.gov. This Federal Register notice, 
as well as news releases and other relevant information, also are 
available on the OSHA Web page at http://www.osha.gov.

SUPPLEMENTARY INFORMATION: 

I. Background

    On May 6, 2010, OSHA published a Request for Information, entitled 
``Infectious Diseases'' (Docket Number: OSHA-2010-0003). The Agency was 
interested in more accurately characterizing the nature and extent of 
occupationally-acquired infectious diseases and the strategies that are 
currently being used to mitigate the risk of occupational exposure to 
infectious agents. More than 200 comments were received in response to 
the RFI. Based upon these responses and an ongoing review of current 
literature on this subject, OSHA is considering what action, if any, 
the Agency should take to limit the spread of occupationally-acquired 
infectious diseases.
    One action the Agency is considering is the development of a 
program standard to control workers' exposure to infectious agents in 
settings, either where workers provide direct patient care or where 
workers perform tasks other than direct patient care which also have 
occupational exposure. These other tasks might include such tasks as: 
Providing patient support services (e.g., housekeeping, food delivery, 
facility maintenance); handling, transporting, receiving or processing 
infectious items

[[Page 39042]]

or wastes (e.g., laundering healthcare linens, transporting medical 
specimens, disposing of medical waste, reprocessing medical equipment); 
maintaining, servicing or repairing medical equipment that is 
contaminated with infectious agents; conducting autopsies (e.g., in 
medical examiners' offices); performing mortuary services; and 
performing tasks in laboratories (e.g., clinical, biomedical research, 
production laboratories) that result in occupational exposure.
    A typical OSHA program standard affords employers substantial 
flexibility in determining the best way to tailor protective measures 
to their workplaces. Program standards generally involve: A hazard 
assessment; a written exposure control plan; methods of compliance 
(e.g., engineering controls, work practice controls, administrative 
controls, and personal protective equipment); medical surveillance; 
worker training; signage and labeling; and recordkeeping. A program 
standard to control occupational exposure to infectious diseases would 
likely incorporate all these elements.
    The Agency has determined that informal discussion with 
stakeholders would be beneficial to its further deliberations on how to 
proceed with respect to occupational exposure to infectious diseases. 
To this end, OSHA will conduct stakeholder meetings, as announced in 
this notice.

II. Stakeholder Meetings

    The stakeholder meetings announced in this notice will be conducted 
as group discussions on views, concerns, and issues surrounding the 
hazards of occupational exposure to infectious agents and how best to 
control them. To facilitate as much group interaction as possible, 
formal presentations by stakeholders will not be permitted. The 
stakeholder meeting discussions will center on such major issues as:
     Whether and to what extent an OSHA standard on 
occupational exposure to infectious diseases should apply in settings 
where workers provide direct patient care, as well as, settings where 
workers have occupational exposure even though they don't provide 
direct patient care. Whether and to what extent there are any other 
settings where an OSHA standard should apply.
     The advantages and disadvantages of using a program 
standard to limit occupational exposure to infectious diseases, and the 
advantages and disadvantages of taking other approaches to organizing a 
prospective standard.
     Whether and to what extent an OSHA standard should require 
each employer to develop a written worker infection control plan (WICP) 
that documents how the employer will implement the infection control 
measures it will use to protect the workers in its facility. Some of 
the elements that might be appropriate to include in such a worker 
infection control plan are: Designation of the plan administrator 
responsible for WICP implementation and oversight; designation of the 
individual(s) responsible for conducting infectious agent hazard 
analyses in the work setting; and written standard operating procedures 
(SOPs) to minimize or prevent exposure to infectious agents (e.g., SOPs 
for early identification of potentially infectious individuals and for 
implementation of standard and transmission-based precautions).
     Whether and to what extent SOP development should be based 
upon consideration of applicable regulations/guidance issued by the 
Centers for Disease Control and Prevention, the National Institutes of 
Health, and other authoritative agencies/organizations.
     Whether and to what extent an OSHA standard should require 
each employer to implement its WICP through a section addressing 
methods of compliance. OSHA envisions that this section would require, 
among other control measures, that an employer conduct an infectious 
agent hazard analysis, follow appropriate SOPs, institute appropriate 
engineering, work practice, and administrative controls, provide and 
ensure the use of appropriate personal protective equipment, clean and 
decontaminate the worksite, and conduct prompt exposure investigations.
     Whether and to what extent an OSHA standard should require 
each employer to make available routine medical screening and 
surveillance, vaccinations to prevent infection, and post-exposure 
evaluation and follow-up to all workers who have been exposed to a 
suspected or confirmed source of an infectious agent(s) without the 
benefit of appropriate infection control measures.
     Whether and to what extent an OSHA standard should contain 
signage, labeling, and worker training requirements to ensure the 
effectiveness of infection control measures.
     Whether and to what extent an OSHA standard should require 
the employer to establish and maintain medical records, exposure 
incident records, and records of reviews of its worker infection 
control program, and whether and to what extent an OSHA standard should 
contain other recordkeeping requirements.
     The economic impacts of a prospective standard.
     Whether and to what extent OSHA should take alternative 
approaches to rulemaking to improve adherence to current infection 
control guidelines issued by the Centers for Disease Control and 
Prevention, the National Institutes of Health, and other authoritative 
agencies/organizations.
     Additional topics as time permits.

III. Public Participation

    Approximately 30 participants will be accommodated in each meeting, 
and three hours will be allotted for each meeting. Members of the 
general public may observe, but not participate in, the meetings as 
space permits. The morning and afternoon meetings will cover identical 
information and participants may attend only one session to allow 
greater stakeholder participation. OSHA staff will be present to take 
part in the discussions. Eastern Research Group (ERG), Inc., (110 
Hartwell Avenue, Lexington, MA 02421) will manage logistics for the 
meetings, provide a facilitator, and compile notes summarizing the 
discussion; these notes will not identify individual speakers. ERG also 
will make an audio recording of each session to ensure that the summary 
notes are accurate; these recordings will not be transcribed. The 
summary notes will be posted on the docket for the Infectious Diseases 
Request for Information, Docket ID: OSHA-2010-0003, available at the 
Web site http://www.regulations.gov.
    To participate in one of the July 29, 2011 stakeholder meetings, or 
be a nonparticipating observer, you must submit a notice of intent 
electronically, by facsimile, or by hard copy. OSHA will confirm 
participants, as necessary, to ensure a fair representation of 
interests and to facilitate gathering diverse viewpoints. To receive a 
confirmation of your participation as soon as possible before the 
meeting, register by the date listed in the DATES section of this 
notice. However, registration will remain open until the meetings are 
full. Additional nonparticipating observers that do not register for 
the meetings will be accommodated as space permits. See the ADDRESSES 
section of this notice for the registration Web site, facsimile number, 
and address. To register electronically, follow the instructions 
provided on the Web site. To register by mail or facsimile, please 
indicate the following:
    Name, address, phone, fax, and e-mail.

[[Page 39043]]

    First and second preferences of meeting time.
    Organization for which you work.
    Organization you will represent (if different).
    Stakeholder category: Government, industry, union, trade 
association, insurance, manufacturers, consultants, or other (if other, 
please specify).
    Electronic copies of this Federal Register notice, as well as news 
releases and other relevant documents, are available on the OSHA Web 
page at: http://www.osha.gov.

Authority and Signature

    This document was prepared under the direction of David Michaels, 
PhD, MPH, Assistant Secretary of Labor for Occupational Safety and 
Health, U.S. Department of Labor, 200 Constitution Avenue, NW., 
Washington, DC 20210. This action is taken pursuant to sections 4, 6, 
and 8, Public Law 91-596, 84 STAT. 1590 (29 U.S.C. 653, 655, 657), 
Secretary of Labor's Order No. 4-2010 (75 FR 55355 (Sept. 10, 2010)), 
and 29 CFR part 1911.

    Signed at Washington, DC, on June 29, 2011.
David Michaels,
Assistant Secretary of Labor for Occupational Safety and Health.
[FR Doc. 2011-16742 Filed 7-1-11; 8:45 am]
BILLING CODE 4510-26-P