September 17, 2004

Mr. Lemont Platt, MsEd, CSCS, ACE, ACSM
VP Operations and Technology Plus One Holdings
75 Maiden Lane, Suite 801
New York, NY 10038

Dear Mr. Platt:

Thank you for your May 27, 2004 letter to the Occupational Safety and Health Administration's (OSHA's) Directorate of Enforcement Programs (DEP), requesting clarification of the bloodborne pathogens standard, specifically as it relates to contaminated laundry, sharps containers, and the Hepatitis B vaccine in fitness centers. Please be aware that this response may not be applicable to any questions not delineated within your original correspondence. Your questions and our replies are provided below.

Question 1: Currently, our fitness centers discard laundry soiled with blood or other potentially infectious materials (OPIM) into biohazard waste containers. Should we be discarding these items, and is it appropriate for us to launder them?

Reply: Initially, you must determine whether your fitness centers are covered by the bloodborne pathogens standard, which applies to "all occupational exposure to blood or other potentially infectious materials," see 29 CFR 1910.1030(a). "Occupational exposure" is defined as "reasonably anticipated skin, eye, mucous membrane, or parenteral contact with blood or other potentially infectious materials that may result from the performance of an employee's duties," see 1910.1030(b). The requirements for exposure determinations are set forth in 1910.1030(c)(2).

Normally laundry in a non-healthcare setting would not be covered by the bloodborne pathogens standard. However, if there is "occupational exposure" as defined above and if the laundry is soiled or contaminated with blood or OPIM, it would be necessary for an employer to comply with provisions of the standard. The standard requires that soiled linen should be handled as little as possible and with minimum agitation to prevent exposure to the handler, see 1910.1030(d)(4)(iv)(A). Linen soiled with blood or OPIM which is sent to a facility to be laundered must be placed and transported in specially marked bags that also prevent leakage, see 1910.1030(d)(4)(iv)(A)(1). The standard does not prohibit the employer from laundering on site as long as the laundering is performed by trained individuals utilizing universal precautions. Other provisions on laundry are set forth in 1910.1030(d)(4)(iv).

OSHA does not require that soiled non-disposable linens be discarded. If the soiled linens can be laundered, then there is no reason for the soiled linens to be discarded.

Question 2: How much blood is necessary in order for an item to be considered soiled? Is a drop from shaving, a paper cut, or a pimple enough?

Reply: The determination of whether an item is soiled is not based on actual volume of blood or OPIM, but rather on the potential to release blood or OPIM. The question is whether, when compacted, the item would release blood or OPIM or whether it is possible for dried blood or OPIM to flake off during handling. It is the employer's responsibility to determine whether these criteria are met.

Question 3: Some of our facilities provide razor blades for customers. Are we required to provide sharps containers? If so, how many are required per square foot of bathroom area?

Reply: No. The employer is not required to provide sharps containers because customers, not employees, are exposed to the razor blades.

Question 4: I don't see the relevance of having to provide Hepatitis B shots for employees of a fitness center.

Reply: Fitness center employees normally are not considered to have "occupational exposure," and they are not covered by the standard unless they are trained in first aid and designated as responsible for rendering first aid. See OSHA CPL 02-02-069 [CPL 2-2.69] Section XIII.A.3.C (this OSHA directive is available at the OSHA website noted in the last paragraph of this letter). If the fitness center employee's only exposure is due to being designated as a first-aider and first aid is only a collateral duty, the preventive vaccination series does not have to be offered if the requirements in OSHA CPL 02-02-069 Section XIII.F.8 are met. The vaccine must be offered following the employee's involvement in an incident in which the employee was exposed to blood. The employer must have an exposure control plan in place that details how the Hepatitis B vaccine will be administered to the exposed employee within 24 hours of the incident. Other requirements are set forth in the provisions of the directive mentioned previously.

Thank you for your interest in occupational safety and health. We hope you find this information helpful. OSHA requirements are set by statute, standards, and regulations. Our interpretation letters explain these requirements and how they apply to particular circumstances, but they cannot create additional employer obligations. This letter constitutes OSHA's interpretations of OSHA rules. Also, from time to time we update our guidance in response to new information. To keep apprised of such developments, you can consult OSHA's website at http://www.osha.gov. If you have any further questions, please feel free to contact the Office of General Industry Enforcement at (202) 693-1850.

Sincerely,


Richard E. Fairfax, Director
Directorate of Enforcement Programs