Laundry » Biological Hazards – Infectious Diseases

Workers in hospital settings may be exposed to infectious disease hazards, especially if proper measures to prevent infection are not taken. Examples of infectious disease hazards include seasonal and pandemic influenza; norovirus; Ebola; methicillin-resistant Staphylococcus Aureus (MRSA), among others.

Infectious diseases are caused by agents that can enter the body through one or more different routes, including through the air and through blood. The transmission of infectious agents through the bloodborne route—a specific subset of contact transmission—is defined in the Bloodborne Pathogens (BBP) standard, 29 CFR 1910.1030 (See the Bloodborne Pathogens section below).

See OSHA's Safety and Health Topics Pages for Biological Agents and Bloodborne Pathogens and Needlestick Prevention for more information.

Some of the proper measures to prevent infection might include, for example, using PPE, such as gloves, AND washing hands AND cleaning work surfaces AND properly disposing of sharps. This eTool discusses only some of the proper measures that are necessary to protect workers. Implementing the controls highlighted here alone will not typically protect workers from infection hazards.

Employers must comply with the BBP standard to the extent that standard applies (i.e., to the extent workers have reasonably anticipated contact with blood or other potentially infectious materials (OPIM) that may result from the performance of duties). Employers must also comply with the PPE Standards, 29 CFR 1910 Subpart I, and the OSH Act's General Duty Clause, 29 U.S.C. 654(a)(1), to protect their workers from infectious disease hazards. The General Duty Clause requires each employer to "furnish to each of his employees employment and a place of employment which are free from recognized hazards that are causing or are likely to cause death or serious physical harm to his employees."

In this module, OSHA provides additional guidance specifically for bloodborne pathogens. The laundry can be contaminated with more than just infectious agents in blood. The CDC guidelines note that contaminated textiles and fabrics often contain high numbers of microorganisms from body substances, including blood, skin, stool, urine, vomitus, and other body tissues and fluids.

Bloodborne pathogens are pathogenic microorganisms present in human blood that can cause disease in humans. These pathogens include, but are not limited to, Hepatitis B Virus (HBV), Hepatitis C Virus (HCV), Human Immunodeficiency Virus (HIV) and Viral Hemorrhagic Fevers (e.g. Ebola). [29 CFR 1910.1030(b)]

Contaminated laundry

General

Contaminated laundry is defined in the Bloodborne Pathogens Standard as laundry which has been soiled with blood or other potentially infectious material (OPIM) or may contain sharps. [29 CFR 1910.1030(b)]

Hazards

Employee exposure to blood or other potentially infectious materials (OPIM) through contaminated laundry that was improperly labeled or handled, as well as possible exposure to sharps.

Requirements under OSHA's Bloodborne Pathogens Standard, 29 CFR 1910.1030

OSHA requires employers to ensure that the biosafety officer or other responsible person conducts an exposure determination to determine the exposure of workers to blood or OPIM throughout the hospital setting. [29 CFR 1910.1030(c)(2)(i)].

Recognized Controls and Work Practices

  • Follow normal laundry cycles according to the washer and detergent manufacturer's recommendations.
  • Avoid holding contaminated laundry bags close to the body and do not squeeze them when transporting to avoid punctures from potential syringes/sharps in the bag.
  • Comply with Guidelines for Environmental Infection Control in Health-Care Facilities. Centers for Disease Control and Prevention (CDC) and the Healthcare Infection Control Practices Advisory Committee (HICPAC). Morbidity and Mortality Weekly Report (MMWR) 52 (RR10); 1-42 (June 6, 2003).

For more information, see Hospital-wide Hazards - Bloodborne Pathogens.

Additional Information

Personal protective equipment (PPE)

Requirements under OSHA's Bloodborne Pathogens Standard, 29 CFR 1910.1030

  • Employers must ensure that employees who have contact with contaminated laundry wear protective gloves and other appropriate personal protective equipment, such as gowns, face shields, and masks when they handle, sort, or otherwise have contact with contaminated laundry. [29 CFR 1910.1030(d)(4)(iv)(B)]
  • The use of thick utility gloves when sorting or handling contaminated laundry will provide workers with additional protection.
    • Utility gloves may be decontaminated for re-use if the integrity of the glove is not compromised.
    • However, they must be discarded if they are cracked, peeling, torn, punctured, exhibit other signs of deterioration, or when their ability to function as a barrier is compromised. [29 CFR 1910.1030(d)(3)(ix)(C)]
  • Disposable (single use) gloves shall not be washed or decontaminated for re-use. [29 CFR 1910.1030(d)(3)(ix)(B)]

OSHA requires employers to ensure that the biosafety officer or other responsible person conducts an exposure determination to determine the exposure of workers to blood or OPIM throughout the hospital setting. [29 CFR 1910.1030(c)(2)(i)].

Additional Information

  • Personal Protective Equipment. OSHA Safety and Health Topics Page.
  • Ebola. OSHA Safety and Health Topics Page.
  • Interim Guidance for Environmental Infection Control in Hospitals for Ebola Virus. Centers for Disease Control and Prevention (CDC). Guidance for hospital staff caring for suspected or confirmed Ebola patients. Among other recommendations, guidance provides that hospitals need to ensure that environmental services staff wear recommended personal protective equipment (PPE) to protect against direct skin and mucous membrane exposure of cleaning chemicals, contamination, and splashes or spatters during environmental cleaning and disinfection activities.
Sharps handling

Hazard

Exposure to Bloodborne Pathogens from contaminated laundry that may contain sharps.

Requirements under OSHA's Bloodborne Pathogens Standard, 29 CFR 1910.1030

A safety and health program that includes procedures for appropriate disposal and handling of sharps and follows required practices outlined in the Bloodborne Pathogens Standard.

Contaminated needles and other contaminated sharps shall not be bent, recapped or removed except as noted in 29 CFR 1910.1030(d)(2)(vii)(A) and (d)(2)(vii)(B). Shearing or breaking of contaminated needles is NOT permitted. [29 CFR 1910.1030(d)(2)(vii)]

  • Sharps containerization:
    • Immediately or as soon as feasible, contaminated sharps must be discarded in appropriate containers that are in accordance with the Bloodborne Pathogens standard. [29 CFR 1910.1030(d)(4)(iii)(A)(1)]
    • Containers for contaminated needles and other sharps must be easily accessible, and located as close as is feasible to the immediate areas where needles may be found, including laundries. [29 CFR 1910.1030(d)(4)(iii)(A)(2)]

OSHA requires employers to ensure that the biosafety officer or other responsible person conducts an exposure determination to determine the exposure of workers to blood or OPIM throughout the hospital setting. [29 CFR 1910.1030(c)(2)(i)].

Additional Information