December 21, 1992

Allan D. Morphett, JD
Farmers Insurance Group of Companies
4680 Wilshire Boulevard
Los Angeles, CA 90010

Dear Mr. Morphett:

This is in response to your letter of August 4, addressed to Ms. Patricia K. Clark, former Director, Directorate of Compliance Programs. You asked for clarification regarding the applicability of the Occupational Safety and Health Administration's (OSHA) 29 CFR 1910.1030, Occupational Exposure to Bloodborne Pathogens, to various types or classes of individuals. We apologize for the delay in this response.

We note that you also provide services across the country, where OSHA programs are either under exclusive Federal jurisdiction or OSHA approved, State-operated plans. In areas under Federal OSHA jurisdiction, Federal standards are in force, and our responses to your questions will apply.

The situation you describe in your letter involves individuals that are allowed into the hospital's restricted areas, namely surgery, where occupational exposure to bloodborne pathogens exists. These individuals, employees of another company, are invited into the operating room either by the surgeon or the hospital to test out a new piece of equipment or instrument. You reference our letter dated June 3, 1992 to Ms. Leslie Hodge, Amserv Nurses, Inc., regarding "leased" nurses and you ask about the hospital's duty or duties to this class of individuals and documentation required should there be an inspection or incident at the facility.

First of all, the letter to Ms. Hodge addresses "leased" nurses and that situation differs from that of a manufacturer's representative. In the context of OSHA's standard on bloodborne pathogens, the hospital would still be responsible for providing site-specific training and personal protective equipment and would have the primary responsibility to control potential exposure to its employees, to "leased" nurses, or to manufacturers' representatives. The employer (the hospital) is liable for citations if it fails to do so.

Secondly, you mention multi-employer sites as they relate to the issuance of citations. The [Multi-Employer Citation Policy, OSHA Compliance Directive CPL 2-0.124 and the Field Inspection Reference Manual (FIRM), OSHA Compliance Directive CPL 2.103] provide that on multi-employer worksites, citations normally shall be issued to employers whose employees are exposed to hazards. Additionally, employers who actually create the hazard, employers who are responsible for safety and health conditions at the worksite, and employers who are responsible for actually correcting the hazard normally shall abe cited, whether or not their own employees are exposed. This policy allows flexibility in the application of responsibility to correct and control hazards to which employees are exposed. It should be noted that physicians who are sole practitioners and partners are not employees and medical facilities are not obligated to protect them; however, those facilities must make sure that such individuals do not endanger employees. Physicians who work for professional corporations are normally employees and therefore the medical facility must protect them under the standard.

Your suggestion to address the issue of respective employers' obligations under the bloodborne pathogens standard in the facility's exposure control plan is appropriate. Documentation might also consist of any contractual arrangements in which these arrangements are delineated.

Since the risk of infection with bloodborne pathogens is dependent on the likelihood of exposure to blood or other potentially infectious materials, wherever that exposure may occur, obligations under the bloodborne pathogens standard are triggered by "occupational exposure". The agency, therefore, hopes to protect all employees at risk regardless of their job title or place of employment. Again, a citation will only be issued if an employee is exposed to a hazard.

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 Enforcement Programs]

[Correction 6/2/2005]