October 1, 1992

Ms. Margery M. Scanlin, Ed.D.
Division Director
American Camping Association, Inc.
5000 State Road 67 North
Martinsville, IN 46151-7902

Dear Dr. Scanlin:

This is in response to your inquiry of May 7, concerning the applicability of the Occupational Safety and Health Administration (OSHA) regulation, 29 CFR 1910.1030, "Occupational Exposure to Bloodborne Pathogens." Specifically, you asked about coverage of employees of summer camps and conference/retreat centers. We apologize for the delay in this response.

Employees who have occupational exposure to blood or other potentially infectious materials (OPIM) are covered by this standard. Occupational exposure is defined as reasonably anticipated skin, eye, mucous membrane, or parenteral contact with blood or OPIM that may result from the performance of an employee's duties. One of the central provisions of the standard is that employers are responsible for identifying job classifications which have occupational exposure. Due to the nature of activities in which camp members participate, both minor and major injuries can be expected. Employees who are expected to stabilize or treat these injuries, for example, a camp nurse, may reasonably be expected to have occupational exposure. If counselors, sports coaches, and other staff who work with campers are responsible for rendering first aid, they would also be covered by the standard.

With this in mind, we will answer your specific questions in the order presented in your letter.

1. "To whom in the camp community does the vaccination requirement apply?"

The vaccination requirement, as well as all other provisions of the standard, applies to all employees who have occupational exposure. However, OSHA has recently issued a policy statement specifying that failure to offer the hepatitis B vaccine pre-exposure to employees who render first aid only as a collateral duty will be considered a DE MINIMIS violation carrying no penalties, provided that a number of conditions are met (see enclosed news release).

This new policy does not apply to your employees who render medical assistance or emergency response activities on a regular basis, such as camp nurses, doctors; they must be offered the vaccine pre-exposure, in accordance with paragraphs (f)(1) and (2) of the standard.

2. "Is it adequate to provide the immunization for [only] the camp's health care staff and/or primary first aider?"

The hepatitis B vaccine must be given to all employees who have occupational exposure, with the exception noted above for first aid providers.

3. "Is [the bloodborne] rule intended to apply to camp life-guards at pools, rivers and lakes?"

It is the employer's responsibility to determine which, if any of the employees have occupational exposure. Lifeguards are generally considered to be emergency responders and are therefore considered to have occupational exposure.

4. "Do persons with first-aid training or incidental responsibilities require vaccination?"

The key to this issue is not whether employees have been trained in first aid, but whether they are also designated as responsible for rendering medical assistance. While employees may be trained in first aid and CPR, not all of them will necessarily be designated to render first aid. Employees who primarily provide first aid or emergency response duties must be vaccinated. Employees who are designated to provide first aid as a collateral duty are covered by the first aid policy as described above. The standard excludes employees who perform unanticipated "Good Samaritan acts" from coverage by the standard since such an action does not constitute "occupational exposure."

5. Is it reasonable for the vaccine to be required of seasonal employees?

Yes. An employer is obligated to offer the hepatitis B vaccine to those employees covered by the standard who are currently employed. Those workers with occupational exposure should be offered the required inoculations scheduled in the series while they are in your employ. If the third injection, for instance, would be due after the employee has ended his term of employment, the employer would not be obligated to offer it. If the employee (for example, the camp nurse or doctor) is one who returns to your employ the following season and is required to be offered the hepatitis B vaccine series, it would obviously be to your advantage to see that the series is completed and to arrange for payment for the last dose.

Your health care professional in charge of administering this program should consult the U.S. Public Health Service's recommendations for administering injections when the series is interrupted. Although optimal protection is not conferred until after the third dose, increasing immunity is conferred with each successive dose of the vaccine.

We hope this information is responsive to your concerns. Thank you for your interest in worker safety and health.

Sincerely,



Roger A. Clark, Director
Directorate of Compliance Programs