Source: https://www.osha.gov/memos/2020-05-19/updated-interim-enforcement-response-plan-coronavirus-disease-2019-covid-19
Timestamp: 2020-06-04 01:29:56
Document Index: 535141035

Matched Legal Cases: ['§ 1910', '§ 1910', '§ 1910', '§ 1910', '§ 1913', '§ 1904', 'art 1904', '§ 1904', '§ 1904', '§ 1910', '§ 1910', '§ 1910', '§ 1910']

Updated Interim Enforcement Response Plan for Coronavirus Disease 2019 (COVID-19) | Occupational Safety and Health Administration
This Updated Interim Enforcement Response Plan for Coronavirus Disease 2019 (COVID-19) provides instructions and guidance to Area Offices and compliance safety and health officers (CSHOs) for handling COVID-19-related complaints, referrals, and severe illness reports. On May 26, 2020, the previous memorandum on this topic[1] will be rescinded, and this new Updated Interim Enforcement Response Plan will go into and remain in effect until further notice. This guidance is intended to be time-limited to the current COVID-19 public health crisis. Please frequently check OSHA’s webpage at www.osha.gov/coronavirus for updates.
Eliminating hazards from COVID-19 remains a top priority for OSHA. Because the government and the private sector have taken rapid and evolving steps to slow the virus's spread, protect employees, and adapt to new ways of doing business, at this time, the rate of new cases, new hospitalizations, and deaths are decreasing in most parts of the country. As workplaces reopen, OSHA will continue to ensure safe and healthy conditions for America's working men and women pursuant to the following framework:
Attached to this Updated Interim Enforcement Response Plan are specific enforcement procedures (Attachment 1); a sample employer letter for COVID-19 activities (Attachment 2); a sample hazard alert letter (Attachment 3); a sample alleged violation description for a citation under the general duty clause, Section 5(a)(1), of the Occupational Safety and Health (OSH) Act (Attachment 4); and additional references, including OSHA's prior COVID-19-related enforcement memoranda (Attachment 5).
As more states are taking steps to reopen their economies and workers are returning to their workplaces, OSHA is receiving complaints from affected workers in non-essential businesses. This Updated Interim Enforcement Response Plan takes account of such changes.
Employers must report work-related fatalities to OSHA within eight (8) hours and work-related in-patient hospitalizations, amputations, or losses of an eye within twenty-four (24) hours. Employers must report fatalities that occur within thirty (30) days of a work-related incident, and must report in-patient hospitalizations, amputations, or losses of an eye that occur within twenty-four (24) hours of a work-related incident. After OSHA receives an employer report of a fatality, in-patient hospitalization, amputation, or loss of an eye as a result of a work-related incident, the AD will determine whether to conduct an inspection or a RRI. The RRI is intended to identify any hazards, provide abatement assistance, and confirm abatement. For additional guidance, refer to Rapid Response Investigations Enforcement Procedures at www.osha.gov/memos/2016-03-04/revised-interim-enforcement-procedures-reporting-requirements-under-29-cfr-190439.
Prior to any inspection related to COVID-19, each AD should evaluate the potential risk level of exposure to SARS-CoV-2 at the workplace, and prioritize his or her resources. When the AD determines an on-site inspection is warranted in light of this Updated Interim Enforcement Response Plan, CSHOs must carefully evaluate potential hazards and limit any possible exposure(s). Throughout their engagement with facilities treating a significant number of COVID-19 patients, CSHOs should take care to avoid interference with the provision of ongoing medical services and critical work efforts.
Whenever CSHOs identify a workplace with potential exposure to SARS-CoV-2—and determine that an inspection is warranted under this Updated Interim Enforcement Response Plan—they should immediately coordinate with their supervisors and regional office, and, if necessary, contact the Office of Occupational Medicine and Nursing (OOMN). OOMN may then serve as a liaison with relevant public health authorities, and can facilitate Medical Access Orders (MAOs) to obtain worker medical records from employers and healthcare providers.
Attached is specific inspection and citation guidance for potentially applicable standards, which describes when to exercise enforcement discretion, such as for the Respiratory Protection standard, 29 CFR § 1910.134. Please refer to other current COVID-19 enforcement memoranda as appropriate. If you have any questions regarding this policy, please contact the Office of Health Enforcement at (202) 693-2190.
{Correction 5/26/2020}
Workplace Risk Levels:
Medium exposure risk jobs include those with frequent and/or close contact with, i.e., within 6 feet of, people who may be (but are not necessarily known to be) infected with SARS-CoV-2. Workers in this risk group may have frequent contact with travelers returning from international locations with widespread COVID-19 transmission. In areas where there isongoing community transmission, workers in this category include, but are not limited to, those who have frequent and/or close contact with the general public or coworkers (e.g., in schools, high-population-density work environments – like meat and poultry processing, and some high-volume retail settings).
Complaints, Referrals, and Rapid Response Investigations (RRIs):
As the virus's spread now slows in certain areas of the country, states are taking steps to reopen their economies and workers are returning to their workplaces. However, because of continuing concerns about COVID-19, OSHA should anticipate COVID-19-related complaints from non-essential industries. In areas where community spread of COVID-19 has significantly decreased and complaints or referrals are received regarding workplaces with medium or low risk, OSHA is expected to follow normal procedures, in accordance with the Field Operations Manual (FOM), CPL 02-00-164 (i.e., make only minor modifications, as necessary). In most cases, fatalities, imminent danger reports and life-critical unprogrammed activities (e.g., falls, struck-by, caught-in/between, or electrocutions) will result in on-site inspections. Formal complaints, such as complaints related to SARS-CoV-2 exposures in meat processing, may also be inspected on-site, based on case-specific facts or resource limitations constraining such investigations.
In high-risk workplaces or where a local area is experiencing either a sustained elevated community transmission or a resurgence in community transmission, Area Offices are to follow the modified procedures below. Complaint(s) or referral(s) for any general industry, maritime, or construction operation alleging potential exposures to SARS-CoV-2 should be handled in accordance with the general procedures in Field Operations Manual (FOM) Chapter 9, Complaint and Referral Processing, except that this response plan modifies the FOM instruction, “the employer is notified of the alleged hazard(s) or violation(s) by telephone, fax, email, or by letter,” by mandating an initial notification by phone to the employer. Additional modified procedures are:
Fatalities and imminent danger exposures related to COVID-19 will be prioritized for inspections. During this pandemic, formal complaints alleging unprotected exposures to COVID-19 for workers with a high/very high risk of transmission, such as a fatality that is potentially related to exposures to confirmed or suspected COVID-19 patients while performing aerosol-generating procedures without adequate PPE in a hospital, should warrant an on-site or remote inspection. The Area Director (AD) should prioritize resources and consider all relevant factors, such as whether the complainant alleges inadequate PPE due to supply issues, in determining whether to perform a non-formal phone/fax investigation instead of an on-site inspection. See Section I above for a description of other workplaces considered to have high/very risk of exposures to COVID-19.
Where resources are insufficient to allow for on-site inspection of a fatality or imminent danger event, the inspections for these types of reported events will be initiated remotely with an expectation that an on-site component will be performed if/when resources become available. Where limitations on resources are such that neither an on-site or remote inspection is possible, OSHA will investigate these types of reported events using a rapid response investigation (RRI) to identify any hazards, provide abatement assistance, and confirm abatement.
OSHA will develop a program to conduct monitoring inspections from a randomized sampling of fatality or imminent danger cases where inspections were not conducted in accordance with normal procedures due to resource limitations.
All other formal complaints alleging SARS-CoV-2 exposure, where employees are engaged in medium or lower exposure risk tasks (e.g., billing clerks), might not result in an on-site inspection, depending on the discretion of the AD where non-formal procedures can sufficiently address the alleged hazards. Inadequate responses to a phone/fax investigation should be considered for an on-site inspection in accordance with the FOM. See Attachment 2 for a sample letter for employers.
Non-formal complaints and referrals related to COVID-19 exposures will be investigated using non-formal processing to expedite employers' attention to alleged hazards.
Employer-reported hospitalizations will be handled using a RRI in most cases. Refer to procedures in the OSHA Memorandum on RRIs dated March 4, 2016, for further information on RRI processing.
In all phone/fax correspondences, Area Offices will assist employers by directing them to publicly-available guidance documents on protective measures, e.g., OSHA's COVID-19 webpage at www.osha.gov/coronavirus.
Workers requesting inspections, complaining of COVID-19 exposure, or reporting illnesses may be covered under one or more whistleblower statutes. Inform them of their protections from retaliation and refer them to www.whistleblowers.gov for more information.
Inspection Scope, Scheduling, and Procedures:
Inspection Planning and Compliance Safety and Health Officer (CSHO) Training. Facilities identified in Section I, above, as having high and very high exposure risk jobs, such as hospitals, emergency medical centers, and emergency response facilities, will frequently be the focus of any inspection activities in response to COVID-19-related complaints/referrals and employer-reported illnesses. Based on information received by an Area Office, the AD will make determinations about when to conduct an on-site facility inspection and when to open remotely by making a phone call.
ADs or Assistant Area Directors shall ensure that CSHOs performing COVID-19-related inspections are familiar with the most recent Centers for Disease Control and Prevention (CDC) guidelines and OSHA's guidance for workplaces in which workers may have exposure to SARS-CoV-2, and that they are adequately trained through either related course work or field experience in appropriate settings. In healthcare, this might include OSHA Training Institute coursework (e.g., OSHA #3360 - Healthcare) or field experience in healthcare facilities. CSHOs shall be made aware of the individual characteristics and underlying conditions that, according to CDC, increase risk for developing severe illness and complications from COVID-19. These risk factors include:
NOTE:Where inspections require coordination with other federal agencies, such as the Centers for Medicare & Medicaid Services (CMS) or local and state health departments, Area Offices should contact the National Office to determine potential involvement of external authorities and coordinate efforts to maximize efficiencies and maintain controls.
Inspection Procedures. Inspection procedures in FOM Chapter 3 shall be followed, except as modified below. CSHOs should consult OSHA directives, appendices, and other references cited in this instruction for further guidance.
Opening Conference. If the formal inspection can be conducted without accessing a location of suspected or confirmed SARS-CoV-2 exposure, then all possible steps must be taken for CSHOs to avoid such exposure(s). For example, opening conferences may be conducted by phone. When onsite, CSHOs will attempt to conduct an opening conference in a designated, uncontaminated administrative area or outdoors. Healthcare facilities generally have internal infection control and employee health and safety programs that may be administered by a team or individual. As appropriate to the setting, CSHOs should ask to speak to the infection control director, safety director, and/or the health professional responsible for occupational health hazard control. Other individuals responsible for providing records pertinent to the inspection should also be included in the opening conference or interviewed early in the inspection (e.g., facility administrator, training director, facilities engineer, director of nursing, human resources, etc.).
Determine whether the employer has a written pandemic plan as recommended by the CDC.[2] If this plan is a part of another emergency preparedness plan, the review does not need to be expanded to the entire emergency preparedness plan (i.e., a limited review addressing issues related to exposure to pandemics would be adequate). The evaluation of an employer's pandemic plan may be based upon other written programs and, in a hospital, a review of the infection control plan.
Review the facility's procedures for hazard assessment and protocols for PPE use with suspected or confirmed COVID-19 patients.
Review other relevant information, such as medical records related to worker exposure incident(s), OSHA-required recordkeeping, and any other pertinent information or documentation deemed appropriate by the CSHO. This includes determining whether any employees have contracted COVID-19, have been hospitalized as a result of COVID-19, or have been placed on precautionary removal/isolation.
Determine if the facility has airborne infection isolation rooms/areas, and gather information about the employer's use of air pressure monitoring systems and any periodic testing procedures.[3] Review any procedures for assigning patients to those rooms/areas and procedures to limit access to those rooms/areas only by employees who are trained and adequately outfitted with
NOTE 1: The CDC currently recommends that healthcare personnel (HCP) who are providing direct care of patients with known or suspected COVID-19 implement robust infection control procedures. These include engineering controls (e.g., airborne infection isolation rooms), administrative controls (e.g., cohorting patients, designated HCP), work practices (e.g., handwashing, disinfecting surfaces), and appropriate use of PPE, such as gloves, face shields or other eye protection, and gowns.[4]
Walkaround. Based on information from the program and document review and interviews, CSHOs and supervisors or ADs should use professional judgment in determining which areas of the facility will be inspected (e.g., emergency rooms, respiratory therapy areas, bronchoscopy suites, and morgue). CSHOs should not enter patient rooms or treatment areas while high hazard procedures are being conducted. Photographs or videotaping where practical should be used for case documentation, such as recording smoke-tube testing of air flows inside or outside an AIIR. However, under no circumstances shall CSHOs photograph or take video of patients, and CSHOs must take all necessary precautions to assure and protect patient confidentiality. Throughout their engagement with facilities treating a significant number of COVID-19 patients, CSHOs should take care to avoid interference with the facilities' ongoing medical services.
Compliance Officer Protection. ADs and Assistant Area Directors will ensure that CSHOs performing COVID-19-related inspections are familiar with the most recent CDC guidelines and OSHA's guidance for healthcare workers, and trained as mentioned above. Supervisors and CSHOs should also review ADM 04-00-002, OSHA Safety and Health Management System (SHMS), including Chapter 8, Personal Protective Equipment, and Chapter 19, Bloodborne Pathogens.[5] Consultation with the regional office is encouraged prior to beginning such inspections.
Vaccinations for COVID-19 are currently not available. CSHOs who conduct COVID-19 inspections are encouraged to get the COVID-19 vaccinations if and when they become available. At such a time, CSHOs should check for Federal Occupational Health (FOH) facility locations within their area to obtain the vaccination(s). CSHOs should also be encouraged to take the seasonal influenza vaccine, ADs and Assistant Area Directors must ensure that appropriate PPE is available for CSHOs conducting on-site activities. CSHOs should determine from the employer where donning, doffing, and decontamination can be done, as well as the location of additional PPE (if available) and decontamination waste disposal facilities, in preparation for the walkaround. COVID-19 can be contracted via person-to-person contact and respiratory droplets, so strict adherence to use of PPE is essential. The minimum level of respiratory protection for CSHOs is a fit-tested half-mask elastomeric respirator with at least an N95 rated filter. CSHOs must also be equipped, at a minimum, with goggles or face shields, disposable gloves, and disposable gowns or coveralls of appropriate size. CSHOs must also ask employers if there are any facility-imposed PPE requirements and adhere to those PPE requirements during the inspection.
Under circumstances where CSHOs need to test a room's ventilation or air flow (e.g., rooms where aerosol-generating procedures are performed), CSHOs shall, at a minimum, wear a half-mask negative-pressure respirator with at least N95 filters, goggles, and disposable gloves. If CSHOs wear full-face, negative-pressure respirators, the respirator takes the place of the goggles for the purposes of providing eye protection.
NOTE: OSHA's Bloodborne Pathogens standard (29 CFR § 1910.1030) applies to occupational exposure to human blood and other potentially infectious materials that typically do not include respiratory secretions that may contain SARS-CoV-2 (unless visible blood is present). However, the provisions of the standard offer a framework that may help control some sources of the virus, including exposures to body fluids (e.g., respiratory secretions) not covered by the standard.
Observation of hazards. Where no violations of OSHA standards, regulations, or the general duty clause are observed or documented, CSHOs shall terminate the inspection and immediately leave the facility.
Citation Guidance. The above standards and requirements should be evaluated for elevated occupational exposure risk as defined in this memorandum. The list is not exhaustive. Violations of OSHA standards cited under the inspection guidance in this memorandum will normally be classified as serious.
General Duty Clause. If deficiencies not addressed by OSHA standards or regulations are discovered in the employer's preparedness for controlling elevated occupational exposure risk for SARS-CoV-2, and guidance is available (e.g., CDC), follow the FOM guidance for obtaining evidence of a potential general duty clause violation, including the four required elements: (1) The employer failed to keep the workplace free of a hazard to which employees of that employer were exposed; (2) The hazard was recognized; (3) The hazard was causing or was likely to cause death or serious physical harm; and, (4) There was a feasible and useful method to correct the hazard.
Unless the case file evidence establishes that all four of the above elements, the Area Office should issue a hazard alert letter (HAL) recommending the implementation of protective measures that address SARS-CoV-2 hazards. For example, if there is no evidence that an employee was potentially exposed to the virus in the workplace, then the first element is not met. See Attachment 3 for a sample HAL.
Use of CDC recommendations. The most current CDC guidance should be consulted in assessing potential workplace hazards and to evaluate the adequacy of an employer's protective measures for workers. Where the protective measures implemented by an employer are not as protective as those recommended by the CDC, the CSHO should consider whether employees are exposed to a recognized hazard and whether there are feasible means to abate that hazard.
Citation Review. In all cases where the AD determines that an OSHA standard has been violated or a condition exists warranting issuance of a 5(a)(1) violation for an occupational exposure to SARS-CoV-2, the proposed citation shall be reviewed with the Regional Administrator and the National Office prior to issuance. In most potential general duty clause cases, it is advisable that the Regional Offices consult with their Regional Solicitor. See Attachment 4 for a sample alleged violation description (AVD).
A record concerning an employee's work-related exposure to SARS-CoV-2 is an employee exposure record under 29 CFR § 1910.1020(c)(5). A record of COVID-19 medical test results, medical evaluations, or medical treatment is considered an employee medical record within the meaning of 29 CFR § 1910.1020(c)(6). Medical records are to be handled in accordance with the procedures set forth at 29 CFR § 1913.10, Rules of Agency Practice and Procedure Concerning OSHA Access to Employee Medical Records.
For purposes of OSHA injury and illness recordkeeping, cases of COVID-19 are not considered a common cold or seasonal flu. The work-relatedness exception for the common cold or flu at 29 CFR § 1904.5(b)(2)(viii) does not apply to these cases. Note that OSHA had been exercising enforcement discretion for the recording of COVID-19 cases, given the nature of the disease and ubiquity of community spread, which initially made it difficult for some employers to determine whether a COVID-19 illness is work-related. As transmission and prevention of infection have become better understood, employers may be better able to identify where an employee's covid-19 illness is likely work-related, e.g., if the employee while on the job has frequent, close contact with the general public in a locality with ongoing community transmission and there is no alternative explanation. Recently, OSHA provided updated guidance for all employers. See OSHA Memorandum, Revised Enforcement Guidance for Recording Cases of 2019 Coronavirus Disease (COVID-19) on OSHA Injury and Illness Logs, issued on May 19, 2020, www.osha.gov/memos/2020-05-19/revised-enforcement-guidance-recording-cases-coronavirus-disease-2019-covid-19.
NOTE: Several types of facilities in the healthcare industry are partially exempt from recordkeeping requirements under 29 CFR Part 1904 and are, therefore, not expected to maintain OSHA 300 logs.[6] CSHOs should rely on interviews and other records reviewed during the investigation at these facilities. {Although facilities in these industries are exempt from maintaining OSHA 300 logs, they are not exempt from the reporting requirements under 29 CFR § 1904.39(a)(1) or 29 CFR § 1904.39(a)(2).}
Equipment Shortages. Because of the increased demand for N95 filtering facepiece respirators (FFRs) during the COVID-19 outbreak, and the resulting limitations on the availability of these respirators for use in protecting workers in healthcare and emergency response from exposure to the virus, the President directed the Secretary of Labor to "consider all appropriate and necessary steps to increase the availability of respirators." [7]
The outbreak is also resulting in shortages of other disposable respirators, surgical masks, and fit-testing supplies and equipment. And health services by fit-testing companies and by medical providers for respirator evaluations may be limited.
Enforcement Discretion. In view of these shortages and limitations, OSHA has provided specific enforcement discretion, as described below, for CSHOs enforcing the Respiratory Protection standard, 29 CFR § 1910.134, during the present COVID-19 outbreak. CSHOs are to refer to the memoranda listed below (also listed in Attachment 5), and should continue to check for additional or modified guidance:
OSHA Memorandum - Enforcement Guidance on Decontamination of Filtering Facepiece Respirators in Healthcare During the Coronavirus Disease 2019 (COVID-19) Pandemic, April 24, 2020, www.osha.gov/memos/2020-04-24/enforcement-guidance-decontamination-filtering-facepiece-respirators-healthcare.
CSHOs should assess whether the employer is making good-faith efforts to provide and ensure workers use the most appropriate respiratory protection available for exposures to SARS-CoV-2. Below is a summary of key guidance from the above memoranda. CSHOs should also consult the memoranda themselves for complete details of OSHA's enforcement policies on the Respiratory Protection standard during the outbreak. The employer's good faith efforts should be accomplished through, in order:
Equipment certified in accordance with standards of other countries or jurisdictions except the People's Republic of China, unless equipment certified in accordance with standards of the People's Republic of China is manufactured by a NIOSH certificate holder, in accordance with OSHA's April 3, 2020 memo; then
Equipment certified in accordance with standards of the People's Republic of China, the manufacturer of which is not a NIOSH certificate holder, in accordance with OSHA's April 3, 2020 memo; then
Prioritizing efforts to acquire and use equipment that has not exceeded its manufacturer's recommended shelf life before allowing workers to use equipment that is beyond its manufacturer's recommended shelf life. Equipment used beyond its manufacturer's recommended shelf life must be used in accordance with OSHA's April 3, 2020 memo.
Prioritizing efforts to use equipment that has not exceeded its intended service life (e.g., disposable FFRs used for the first time) before implementing protocols for extended use or reuse of equipment. Extended use or reuse of equipment should follow the CDC's Strategies for Optimizing the Supply of N95 Respiratorsand OSHA's April 3, 2020 memo.
CSHOs should also confirm that workers perform a user seal check each time they don a respirator, regardless of whether it is a NIOSH-certified device or device certified under standards of other countries, and do not use a respirator on which they cannot perform a successful user seal check. See 29 CFR § 1910.134, Appendix B-1, User Seal Check Procedures.[8]
Finally, CSHOs should confirm that employers and users of personal protective equipment avoid co-mingling products from different categories of equipment. That is, NIOSH-certified equipment, equipment that was previously NIOSH-certified but that has surpassed its manufacturer's recommended shelf life, equipment certified under standards of other countries, and equipment that was previously certified under standards of other countries but that has surpassed its manufacturer's recommended shelf life, should be stored separately.
Workers are using respirators (including N95 FFRs; other FFRs; non-disposable, elastomeric respirators; or PAPRs) that are still within their manufacturer's recommended shelf life, if available, before using respirators that are beyond their manufacturer's recommended shelf life.
Workers are using respiratory protection equipment certified exclusively in accordance with standards of the People's Republic of China and manufactured by companies that are not NIOSH approval holders only when a facemask or improvised nose/mouth cover is the only feasible alternative.
Workers are not using expired respiratory protection equipment if respirators are available that are still within their manufacturer's recommended shelf life.
NOTE: It is reasonable for healthcare employers to reserve some NIOSH- or foreign-certified N95 FFRs or better respirators for use by healthcare workers who are expected to perform surgical procedures on patients infected with, or potentially infected with, SARS-CoV-2, or perform or are present for procedures expected to generate aerosols or procedures where respiratory secretions are likely to be poorly controlled. In such cases, and particularly when workers performing other tasks are provided with adequate alternative equipment, employers should be able to provide a reasonable rationale for their decision to stockpile these respirators. See also www.cdc.gov/coronavirus/2019-ncov/hcp/respirators-strategy/contingency-capacity-strategies.html. The CDC guidance also addresses scenarios in which other crisis standards of care may need to be considered, but this enforcement guidance is not intended to cover those scenarios.
Other feasible measures, such as using partitions, restricting access, cohorting patients (healthcare), or using other engineering controls, work practices, or administrative controls that reduce the need for respiratory protection, were effectively implemented to protect employees.
The employer has made a good faith effort to obtain other appropriate, alternative FFRs, reusable elastomeric respirators, or powered air-purifying respirators (PAPRs), including NIOSH-certified equipment or equipment that was previously NIOSH-certified, but that has surpassed its manufacturer's recommended shelf life (in accordance with OSHA's April 3 memo);
In addition, OSHA is aware that the current pandemic has created an increased demand for some protective equipment, limiting availability for use in protecting workers from exposure to the virus. If this situation has prevented you from furnishing protective equipment to your employees, you should provide documentation of the efforts you have made to obtain that equipment. Please feel free to contact the office at [AO phone] if you have any questions or concerns. [If the complaint is at a CMS certified facility add the following: We are also advising you that OSHA will notify the Centers for Medicare & Medicaid Services (CMS) of substantiated complaints for their consideration].
NOTE: See also OSHA's website at www.osha.gov/coronavirus for certain temporary enforcement policies for this espiratory Protection standard during the COVID-19 pandemic.
Hospital Preparedness Assessment Tool, www.cdc.gov/coronavirus/2019-ncov/downloads/HCW_Checklist_508.pdf. Also, for Infection Control Guidance, www.cdc.gov/oralhealth/infectioncontrol/statement-COVID.html.
This general alleged violation description (AVD) language below is presented as an example to assist Compliance Safety and Health Officers (CSHOs) in developing citations under the general duty clause, Section 5(a)(1), of the Occupational Safety and Health (OSH) Act. Citations should be drafted in consultation with the Regional Solicitor to reflect specific conditions found at establishments and to give notice to employers of the particular hazardous condition or practice cited.
Section 5(a)(1) of the Occupational Safety and Health Act: The employer did not furnish employment and a place of employment which were free from recognized hazards that were causing or likely to cause death or serious physical harm to employees, in that employees were not protected from the hazard of contracting SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), the cause of Coronavirus Disease 2019 (COVID-19).
(a) (LOCATION) (DATE) (IDENTIFY SPECIFIC OPERATION/TASK(S) AND DEPARTMENTS, DESCRIBE CONDITIONS, INCLUDING EXPOSURE LEVELS) In the emergency room staffed with 35 employees, on 4/3/20: Three employees, a physician, nurse, and nursing assistant, were providing direct patient care - performing a routine endotracheal intubation procedure - to a patient who was previously confirmed to be infected with SARS-CoV-2. The employer did not ensure that appropriate and available engineering controls were used to protect against infective respiratory droplets and aerosols, in that an available isolation room was not used for the procedure, thereby exposing adjacent unprotected workers to SARS-CoV-2.[9]
Preventing Worker Exposure to Coronavirus (COVID-19), (OSHA publication 3989), www.osha.gov/Publications/OSHA3989.pdf.
COVID-19 Guidance for the Construction Workforce, (OSHA publication 4000), www.osha.gov/Publications/OSHA4000.pdf.
COVID-19 Guidance for Dental Practitioners, (OSHA publication 4019), www.osha.gov/Publications/OSHA4019.pdf.
COVID-19 Guidance for Retail Pharmacies, (OSHA publication 4023), www.osha.gov/Publications/OSHA4023.pdf.
COVID-19 Guidance for Nursing Home and Long-Term Care Facility Workers, (OSHA publication 4025), www.osha.gov/Publications/OSHA4025.pdf.
Joint OSHA-CDC guidance: Manufacturing Workers and Employers, www.cdc.gov/coronavirus/2019-ncov/community/guidance-manufacturing-workers-employers.html.
Joint OSHA-CDC guidance: Meat and Poultry Processing, www.cdc.gov/coronavirus/2019-ncov/community/organizations/meat-poultry-processing-workers-employers.html.
OSHA Memorandum - Discretion in Enforcement when Considering an Employer's Good Faith Efforts During the Coronavirus Disease 2019 (COVID-19) Pandemic, April 16, 2020, www.osha.gov/memos/2020-04-16/discretion-enforcement-when-considering-employers-good-faith-efforts-during.
OSHA Memorandum - Revised Enforcement Guidance for Recording Cases of 2019 Coronavirus Disease (COVID-19) on OSHA Injury and Illness Logs, May 19, 2020, www.osha.gov/memos/2020-05-19/revised-enforcement-guidance-recording-cases-coronavirus-disease-2019-covid-19.
www.osha.gov/laws-regs/regulations/standardnumber/1910/1910.134;
www.osha.gov/SLTC/respiratoryprotection/index.html.
OSHA Personal Protective Equipment standard, 29 CFR § 1910.132:
www.osha.gov/laws-regs/regulations/standardnumber/1910/1910.132;
www.osha.gov/SLTC/personalprotectiveequipment/index.html.
OSHA Sanitation standard, 29 CFR § 1910.141:
www.cdc.gov/coronavirus/2019-ncov/community/organizations/businesses-employers.html;
www.cdc.gov/coronavirus/2019-ncov/php/building-water-system.html;
www.cdc.gov/coronavirus/2019-ncov/community/clean-disinfect/index.html;
www.cdc.gov/coronavirus/2019-ncov/hcp/managing-workplace-fatigue.html.
www.cdc.gov/coronavirus/2019-ncov/community/conserving-respirator-supply.html;
www.cdc.gov/coronavirus/2019-ncov/hcp/respirator-supply-strategies.html#ppe-respiratory-protection;
www.cdc.gov/coronavirus/2019-ncov/release-stockpiled-N95.html;
www.cdc.gov/niosh/topics/hcwcontrols/recommendedguidanceextuse.html.
www.phe.gov/about/sns/Pages/default.aspx. For further questions or information about the SNS, contact sns.ops@cdc.gov.
Guidance on disinfectants, water, and wastewater: www.epa.gov/coronavirus.
[1] OSHA Memorandum, Interim Enforcement Response Plan for Coronavirus Disease 2019 (COVID-19), April 13, 2020, www.osha.gov/memos/2020-04-13/interim-enforcement-response-plan-coronavirus-disease-2019-covid-19. Back to Text
[2] See www.cdc.gov/coronavirus/2019-ncov/hcp/hcp-hospital-checklist.html. Back to Text
[3] Airborne Infection Isolation Room (AIIR): A room designed to maintain Airborne Infection Isolation (AII). AIIRs are single-occupancy patient-care rooms used to isolate persons with suspected or confirmed infectious disease. Environmental factors are controlled in AIIRs to minimize the transmission of infectious agents that are usually spread from person to person by droplet nuclei associated with coughing or aerosolization of contaminated fluids. AIIRs should be maintained under negative pressure (so that air flows under the door gap into the room), at an air flow rate of 6–12 air changes per hour, and there should be direct exhaust of air from the room to the outside of the building or recirculation of air through a high-efficiency particulate air (HEPA) filter. Back to Text
[4] CDC, Interim Infection Prevention and Control Recommendations for Patients with Suspected or Confirmed Coronavirus Disease 2019 (COVID-19) in Healthcare Settings, at: www.cdc.gov/coronavirus/2019-ncov/infection-control/control-recommendations.html. Back to Text
[5] See www.osha.gov/enforcement/directives/adm-04-00-002. Back to Text
[6] Currently exempt are offices of physicians, {outpatient care centers, and medical and diagnostic laboratories. For the full list, see Appendix A to 29 CFR 1904 Subpart B at: www.osha.gov/laws-regs/regulations/standardnumber/1904/1904SubpartBAppA}. Back to Text
[7] See www.whitehouse.gov/presidential-actions/memorandum-making-general-use-respirators-available/. Back to Text
[9] Centers for Disease Control and Prevention (CDC), Interim Infection Prevention and Control Recommendations for Patients with Suspected or Confirmed Coronavirus Disease 2019 (COVID-19) in Healthcare Settings, at: www.cdc.gov/coronavirus/2019-ncov/infection-control/control-recommendations.html. Back to text