September 20, 1993

Mr. W. William Ament
Organization Resources Counselors, Inc.
1910 Sunderland Place, N.W.
Washington, D.C. 20036

Dear Mr. Ament:

Thank you for your letter dated July 30, requesting interpretations on several bloodborne pathogen issues as they relate to the OSHA injury and illness recordkeeping system. I will repeat each of your questions and follow with my response.

Q1. Is it recordable on the OSHA 200 Log when an employer offers the hepatitis B vaccine series to an unvaccinated designated first-aid provider after this employee assisted in an incident involving blood? No exposure incident (as defined by (b) of the OSHA standard on bloodborne pathogens (1910.1030) occurred.

A1. No, cases that do not involve exposure incidents are not recordable. As stated in on page 6 of CPL 2-2.44C (attached), cases that do involve occupational bloodborne pathogens exposure incidents shall be classified and evaluated as injuries since they are usually the result of an instantaneous event. They shall be recorded if they meet one or more of the following requirements:

1. The incident results in a loss of consciousness, transfer to another job, or a work restriction, or

2. The incident results in the administration or recommendation of medical treatment beyond first aid (e.g., gamma globulin, hepatitis B immune globulin, hepatitis B vaccine, zidovudine, or other prescription medications), or

3. The incident results in a diagnosis of seroconversion.

For recordkeeping purposes, "exposure incident" is defined as "a specific eye, mouth, other mucous membrane, non-intact skin, or parenteral contact with blood or other potentially infectious material..." In addition, "non-intact skin" includes skin with dermatitis, hang-nails, cuts, abrasions, chafing, etc.

Q2. Is it recordable on the OSHA 200 Log when an employer offers the hepatitis B vaccine series to an employee who is not a designated first-aid provider after this employee assisted in an incident involving blood? No exposure incident (as defined by (b) of the OSHA standard on bloodborne pathogens (1910.1030) occurred.

A2. No, cases that do not involve exposure incidents are not recordable (see question 1 above). Recordability under the OSHA injury and illness recordkeeping system is not based on occupation or job title. All employees of the employer are equally covered by the recordkeeping regulations.

Q3. A designated first-aid provider was exposed to blood when assisting an injured employee. After the exposure incident, the first-aid provider was offered hepatitis B immune globulin and the hepatitis B vaccine series. The exposure incident was recorded on the OSHA 200 Log. The injured employee's blood test results indicated that he was not infected with hepatitis B or HIV, or any other bloodborne pathogen. Can the employer then line out the entry on the OSHA 200 Log that recorded the first-aid provider's exposure to blood?

A3. No. A bloodborne exposure incident coupled with medical treatment constitutes a recordable case. The case outlined above meets this criteria and therefore should not be lined out.

Q4. Scenario 1: A splash of blood to open skin, to the mouth, or eyes and the exposed employee is not able to cleanse the exposed area for several minutes to several hours.

Scenario 2: A needle through the skin.

Please comment on the following: With regard to the first scenario, because the exposure was not instantaneous it is an illness and it would only fall under the classification if an abnormal condition or disorder resulted (see page 37 of the BLS Guidelines). Consequently, if there is no abnormal blood test, there can be no illness and the incident would not be recordable. Under the second scenario, since the exposure was instantaneous, it would be an injury and not an illness.

A4. The definition of an occupational bloodborne pathogens exposure incident (as defined in the Bloodborne Standard) does not differentiate between instantaneous and non-instantaneous exposures. The recording criteria for cases involving bloodborne pathogen exposure incidents is based upon this definition. Because these cases are usually triggered by an instantaneous event, it has been decided to classify all bloodborne pathogen cases as injuries at this time and avoid potential privacy issues. These types of cases and issues will be addresses further in any forthcoming recordkeeping revision to keep recordkeeping determinations as simple as possible (See question 1 above).

I hope you find this information useful. If you have any further questions or comments, please contact me at Area Code (202) 219-6463.

Sincerely,



Stephen A. Newell
Director Office of Statistics