September 24, 1993

Ms. Judith A. Brown
Legal Counsel
Care Net
101 West Broad Street
Suite 500
Falls Church, Virginia 22046

Dear Ms. Brown:

Thank you for your letter of August 19 concerning the application of the Occupational Safety and Health Administration's (OSHA) final rule for Occupational Exposure to Bloodborne Pathogens (29 CFR 1910.1030) to pregnancy care centers administering urine pregnancy tests.

In your letter you indicate that the pregnancy testing centers affiliated with Care Net provide on-site urine pregnancy tests. You also indicate that the procedures vary from one facility to another and may involve employees, volunteers, and clients performing various tasks associated with the urine test. As you know, OSHA's jurisdiction extends only to the safety and health of employees in the workplace and does not extend to volunteers or to the general public.

It is important to note that the bloodborne pathogens standard applies to all employees who have occupational exposure to blood or other potentially infectious materials (OPIM). The term "occupational exposure" means all reasonably anticipated contact with blood or other potentially infectious materials that may result from the performance of an employee's duties. Therefore, coverage under the standard is not based on the type of industry or workplace, but rather on the reasonable anticipation of worker exposure to blood or OPIM.

Under the standard, it is the employer's responsibility to evaluate each job classification for occupational exposure, taking into account all circumstances of potential exposure to determine which, if any, employees may come into contact with blood or OPIM as part of their job duties.

Your letter indicates that you anticipate that in a certain percentage of cases employees will be exposed to urine that is contaminated with blood. You correctly note that although urine is not generally considered an infectious material, any body fluid that is visibly contaminated with blood, including urine, is included within the definition of OPIM. Therefore, the reasonable anticipation of worker exposure to urine contaminated with blood would require full compliance with the standard's requirements as would any other "occupational exposure", if the center employees are required to perform the tests and/or dispose of the urine.

We hope this information is useful to you. Thank you for your interest in occupational safety and health.

Sincerely,



Roger A. Clark
Director of Compliance Programs




August 19, 1993

DOL/OSHA/DCP/OHCA
Mr. Roger Clark
200 Constitution Avenue, N.W.
Washington, D.C. 20210

Dear Mr. Clark:

I am writing on behalf of the 450 pregnancy care centers affiliated with Care Net. We would like you to clarify, in writing, the application of the OSHA regulations on bloodborne pathogens, 29 C.F.R. Part 1910.1030 (1991).

Most of our centers provide free urine pregnancy tests, which clients perform on-site. In these centers, generally the procedure is as follows: the client catches her urine in a small container then closes the lid. The client places the closed container on a tray. Usually, a volunteer, but sometimes an employee, carries the tray into a room where the client performs the test and closes the container. After the client leaves the center, the volunteer, wearing gloves, disposes of the urine in a toilet and disposes of the container and the pregnancy test in a plastic-lined trash can. The trash bag is left at the curb for regular trash pick-up. The volunteer then washes the tray, any surface where the tray was, and the bathroom with a bleach solution.

Some of our centers follow essentially the same procedure but only the client handles the urine. At other centers, volunteers perform the pregnancy test and dispose of the urine. Finally, some of our centers are medical clinics. At these clinics, staff perform the tests in a laboratory-like area of the center.

It is my understanding that although urine is not a regulated waste, any body fluid that is visibly contaminated with blood is a regulated waste. OSHA regulations do not apply to volunteers, but our centers do require some employees to perform the above- mentioned tasks. Our centers see over 200,000 clients per year. It is our best estimate that only about one in every 3000 clients catches urine that is visibly contaminated with blood. Furthermore, we have instructed our centers to ask clients to remove contaminated urine from our centers. Therefore, no contaminated urine will be disposed in our centers.

I do not believe that our employees or volunteers are at risk of exposure to bloodborne pathogens. Additionally, as I interpret the regulations, they do not apply to our centers. However, I would like you to officially confirm my interpretation.

We desire to comply with the law and, more importantly, we desire that the employees and volunteers in our centers be protected from unnecessary exposure to bloodborne pathogens. Please advise us of our status according to the regulations. If you conclude that the law requires compliance, please also advise how we can change our procedures if possible in order to change our status.

Thank you for your prompt attention to this matter. I look forward to hearing from you.

Sincerely,



Judith A. Brown
Legal Counsel