June 16, 2006

Patricia N. Jeansonne, M.D.
Pediatric Health Care Alliance, P.A.
811 S. Parsons Avenue
Brandon, FL 33511

Dear Dr. Jeansonne:

Thank you for your letter to the Occupational Safety and Health Administration (OSHA). This letter constitutes OSHA's interpretation only of the requirements discussed and may not be applicable to any question not delineated within your original correspondence. For clarification, your specific question is paraphrased below, followed by OSHA's response.

Question: I am a physician in an office-based pediatric center where our staff generally performs blood draws and urine checks, etc. We do not feel there is a potential for getting blood on our feet, so, as a matter of comfort, our work attire is dressy casual clothes and sandals suitable for a warm climate. We have been told OSHA requires that we wear shoes that cover our toes, or if we choose to wear sandals, we must wear socks with our sandals to make it permissible. Do the OSHA regulations permit the wearing of sandals in a medical office setting where our feet do not contact blood or body fluids?

Reply: When there is occupational exposure to blood or other potentially infectious materials (OPIM), the OSHA bloodborne pathogens standard, 29 CFR 1910.1030, requires the employer to provide, at no cost to the employee, APPROPRIATE personal protective equipment such as, but not limited to, gloves, gowns, eye protection, shoe covers, laboratory coats, or other equipment deemed necessary [See 29 CFR 1910.1030(d)(3)(i)]. Therefore, in circumstances where it is reasonable to anticipate that blood will contact the feet, employers must provide employees with protective gear to cover shoes which will be worn outside. (The bloodborne pathogens standard does not consider shoes worn outside the facility as personal protective equipment, regardless of whether the shoes cover the toes or not.) Personal protective equipment will be considered "appropriate" only if it does not permit blood or other potentially infectious materials to pass through to or reach the employee's work clothes, street clothes, undergarments, skin, eyes, mouth, or other mucous membranes under normal conditions of use and for the duration of time which the protective equipment will be used [See 29 CFR 1910.1030(d)(3)]. As you stated in your letter, socks are not considered a protective barrier for preventing soak-through of blood or other potentially infectious materials (OPIM).

It is the employer's responsibility to ascertain whether or not there is reasonable likelihood of exposure to blood or OPIM at their workplace. Nonetheless, the determination of appropriate footwear in the absence of this (exposure to blood or OPIM) or any other recognized hazard would be up to the employer. OSHA does not forbid employers from setting protocol for prescribed work attire.

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