March 28, 2005

Mr. Frank A. White
ORC Worldwide
1800 K Street, NW
Suite 810
Washington, DC 20006-2226

Dear Mr. White:

Thank you for your September 17, 2004, letter to the Occupational Safety and Health Administration's (OSHA's) Directorate of Enforcement Programs (DEP) regarding the applicability of OSHA's bloodborne pathogens standard (the standard) to the handling and disposal of disposable safety razors in nursing homes. This letter constitutes OSHA's interpretation only of the requirements discussed and may not be applicable to any question(s)/scenario not delineated within your original correspondence. We apologize for the delay in providing you a response. The scenario and specific question you raised in your letter have been rephrased below, followed by OSHA's response.

Scenario: Some state environmental and public health agencies have provided written opinions declaring or advising that disposable razors used for personal grooming should not be considered infectious or otherwise regulated medical waste and should not be disposed of or labeled as a biohazard, but should instead be disposed of in the regular waste stream.

Question 1: Does the standard allow nursing homes to use an empty laundry detergent bucket that bears the appropriate biohazard label and a notation that it is for razors only for the disposal of used razors? When the container is full and closed, can the facility remove or mark out the biohazard sticker at the point the container is disposed of in the regular waste stream?

Reply 1: OSHA's bloodborne pathogens standard states: "Disposal of all regulated waste shall be in accordance with applicable regulations of the United States, States and Territories, and political subdivisions of States and Territories" [CFR 29 1910.1030(d)(4)(iii)(C)]. Thus, long-term care and nursing home facilities must comply with any of these state regulations that describe specific policies regarding the final disposition of used razors, including the requirement that a notation that the containers only contain razors be placed on the container.

OSHA also has requirements to protect workers during the containment, storage, and transport of contaminated sharps, which includes razors used to shave patients in long-term care facilities. Although OSHA does not require specific brands, styles, or size of disposal containers, containers that are used to collect contaminated sharps must meet the requirements set forth in 1910.1030(d)(4)(iii)(A)(1). Among other things, they must be "(i) Closable; (ii) Puncture resistant; (iii) Leakproof on sides and bottom; and, (iv) Labeled or color-coded in accordance with paragraph (g)(1)(i)." It is also required that designated sharps containers be "Replaced routinely and not be allowed to overfill" [1910.1030(d)(4)(iii)(A)(2)(iii)]. It should be noted that reusable containers are not to be opened, emptied, or cleaned manually or in any other manner which would expose employees to risk [1910.1030(d)(4)(iii)(A)(4)].

Any facility that generates regulated waste, including contaminated sharps such as used disposable razors, must provide employees with training on proper work practices regarding transport and containment [1910.1030(g)(2)(vii)(F)].

Question 2: Does the bloodborne pathogens standard allow a nursing home to maintain one sharps disposal container at a central location, e.g., a nurses' station near the areas where nursing home staff assist residents with shaving and simply have employees drop used razors into an emesis basin, plastic cup, or plastic bags to carry them to the disposal container?

Reply 2: The bloodborne pathogens standard requires that, during use, sharps containers must be "[e]asily accessible to personnel and located as close as is feasible to the immediate area where sharps are used or can be reasonably anticipated to be found (e.g., laundries)" [1910.1030(d)(4)(iii)(A)(2)(i)]. The standard also provides: "Contaminated sharps shall be discarded immediately or as soon as feasible" [1910.1030(d)(4)(iii)(A)(1)]. As with sharps containers used for collecting other types of contaminated sharps, designating a central collection site for the location of containers may not meet these requirements. Depending on the size of the facility and location of areas where shaving is performed, you may find that employees are required to walk considerable distances before disposing of used razors. In these cases, locating the containers closer to the point of generation may be feasible and would, therefore, be required by the provision of the standard cited above. One way to ensure the containers are located as close as is feasible would be to train staff members to take note of the availability of a medication cart, treatment cart that has a sharps container on it, or soiled utility room that has a sharps container prior to shaving a resident, if there is no sharps container located inside the room in which the shaving will take place. Staff members should pre-plan and determine the closest area for the razors to be disposed of after shaving a resident.

In addition, employers must ensure that care be taken when moving containers used for the collection of used sharps. Under 1910.1030(d)(4)(iii)(A)(3)(i), the containers must be "[c]losed immediately prior to removal or replacement to prevent spillage or protrusion of contents during handling, storage, transport, or shipping." In those work situations where nursing home staff assist residents with shaving and must then dispose of the razor in a sharps container which is located, for example, outside the room on a treatment cart, specific details regarding safe work practices to address this procedure must be developed and included in each worksite's Exposure Control Plan [1910.1030(c)(1)(ii)(B)]. Safe work practices may include covering the transport container (which contains the used razor) during travel to the treatment cart or other final disposal container, in order to protect the worker from exposure to the blade or the accidental spilling of the container's contents.

Engineering and work practice controls must be instituted as the primary means of eliminating or minimizing employee exposure [1910.1030(d)(2)(i)]. One way in which employers can eliminate the razor blade from the worksite is to utilize electric razors to shave residents. This alternative constitutes an effective engineering control for the protection of employees. It ultimately reduces the amount of regulated waste for the facility, simplifies the staff training time, and is generally well received by the residents.

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 interpretation of the requirements discussed. Note that our enforcement guidance may be affected by changes to 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 Health Enforcement at 202-693-2190.

Sincerely,



Richard E. Fairfax, Director
Directorate of Enforcement Programs

[Corrected December 17, 2007]