September 25, 2000

Brent H. Jaco, ATC, LAT
Head Athletic Trainer
Galveston ISD, Ball High School
4115 Avenue O
Galveston, TX 77550

Dear Mr. Jaco:

Thank you for your June 21 letter to the Occupational Safety and Health Administration (OSHA). Your letter has been referred to OSHA's [Directorate of Enforcement Programs (DEP)] for a response to your questions regarding the coverage of athletic trainers and coaches under OSHA's Bloodborne Pathogens Standard (29 CFR 1910.1030) in a "state independent school district." We apologize for the delay. Please be aware that this response may not be applicable to any questions not delineated within your original correspondence. Your questions are outlined below, followed by our response.

During your August 16 phone conversation with a [DEP] staff member, you clarified the issues established in your original, December 1999 letter. You explained that, as state employees employed in a local high school, you (your colleagues) are responsible for student athletic training, athletic team coaching, handling laundry (e.g., used towels, uniforms, sporting equipment), and administration of first aid.

You are asking for an interpretation of the Bloodborne Pathogens Standard as it applies to "...team physicians and athletic trainers, including student athletic trainers involved in the treatment of abrasions and wounds ... and to coaches that are responsible for handling soiled laundry (uniforms, towels, etc.)." You are also requesting information about the basic requirements of the standard.

OSHA establishes responsibilities and rights for employers and employees to achieve and promote safety and health in the workplace. OSHA's standards only apply to those relationships established between employers and employees and do not extend federal protection to students. Additionally, employees of state and local governments, are not covered by Federal OSHA standards [see 29 USC 652 (5) and (6)]. However, employees of state governments which have adopted their own occupational safety and health enforcement programs are protected by state standards that are "at least as effective as" the Federal OSHA standards. These state programs must be approved by Federal OSHA. There are twenty-six (26) such states but, Texas is not among them, so while private employees in the State of Texas are covered by Federal standards, public employees are not. Therefore, since your questions involve a public school in Texas, there are no Federal OSHA or state plan OSHA standards which apply. You may want to contact your state and local health and education agencies to see if they have any regulations which apply to bloodborne pathogens.

For your information we have included two outreach documents. First, OSHA Publication 2056: All About OSHA, which explains the jurisdiction, scope, and mission of OSHA, including national contact information. Additionally and more specifically regarding bloodborne pathogens, we have included OSHA Publication 3127: Occupational Exposure to Bloodborne Pathogens. These documents, along with OSHA's standards and compliance directives are available on OSHA's website at http://www.osha.gov.

Though the Federal OSHA Bloodborne Pathogens Standard does not apply to your school, you asked that we provide you with some basic information on OSHA's Bloodborne Pathogens (BBP) Standard. In general, the Federal BBP Standard applies to "...all occupational exposure to blood or other potentially infectious materials (OPIM)." For those employees that have a reasonably anticipated exposure to blood or OPIM, the employer is responsible for: (1) establishing a written Exposure Control Plan (ECP) to be reviewed and updated at least annually, (2) instituting engineering and work practice controls in order to eliminate or minimize employee exposure (e.g., sharps containers, safer medical devices), (3) providing appropriate vaccinations and antibody testing (as recommended by the Centers for Disease Control and Prevention (CDC)), (4) providing and ensuring the use of personal protective equipment (PPE) (e.g., gloves), (5) proper handling, shipping, and laundering of contaminated items, (6) proper decontamination of reusable equipment and work surfaces, and (7) the proper disposal of regulated waste [see 29 CFR 1910.1030].

In situations where employees regularly administer first aid or other basic health services, the standard requires compliance with the guidelines set forth for healthcare workers (HCWs) by the CDC. This information is available in the Morbidity and Mortality Weekly Report (MMWR), Public Health Service Guidelines for the Management of Healthcare Worker Exposures to HIV (May 15, 1998) which is available from the CDC and as an appendix in OSHA's Compliance Directive, CPL 2-2.44D, Enforcement Procedures for the Occupational Exposure to Bloodborne Pathogens.

[Corrected 1/17/2005. The CDC document has been revised and is now listed as:
Centers for Disease Control, MMWR, June 29, 2001, Vol.50, No.RR-11, Updated U.S. Public Health Service Guidelines for the Management of Occupational Exposures to HBV, HCV, and HIV and Recommendations for Postexposure Prophylaxis and is available as Appendix E of the revised OSHA Instruction CPL 02-02-069.]

With regard to "soiled laundry," normally laundry in a non-healthcare setting would not be covered by the Bloodborne Pathogens Standard. However, if the laundry is soiled or contaminated with blood or OPIM, it would be necessary for an employee subject to the standard to comply with its provisions. The standard recommends that soiled linen should be handled as little as possible and with minimum agitations to prevent exposure to the handler (employee). Linen soiled with blood or body fluids must be placed and transported in specially marked bags which also prevent leakage. Additionally, laundry must be washed in accordance with the decontamination practices recommended by the CDC.

For further information on the requirements of OSHA's BBP Standard or any other OSHA requirement, please feel free to contact OSHA's Dallas Regional Office at:

U.S. Department of Labor, OSHA
Dallas Area Office
[8344 East RL Thornton Freeway
Suite 420
Dallas, Texas 75228
Phone: (214) 320-2400
Fax: (214) 320-2598]

Thank you for your interest in occupational safety and health. We hope you find this information helpful. Compliance guidance provided by OSHA represents OSHA's explanation, clarification, or application of the provisions of the OSH Act, OSHA standards or OSHA regulations, but it does not add to, alter, or replace those provisions, which alone are legally binding. You should also be aware that OSHA's compliance guidance is subject to periodic review and clarification, amplification, or correction and can also be affected by subsequent rulemaking or other changes in the law. One way for you to track future changes that might affect the information provided herein is by consulting OSHA's website at http://www.osha.gov.

Sincerely,


Richard E. Fairfax, Director
[Directorate of Enforcement Programs]

Attachments: OSHA 2056, OSHA 3127

[Corrected 6/2/2005]