September 9, 2008

Mr. Craig D. Munson
President
Craig Medical Distribution, Inc.
1185 Park Center Drive, Suite P
Vista, CA 92083-8305

Dear Mr. Munson:

Thank you for your letter to the Occupational Safety and Health Administration (OSHA). Your letter was forwarded to OSHA's Directorate of Enforcement Programs for a response. Your question is restated below, followed by OSHA's response. 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.

Scenario: There are two basic types of lancing devices for workplace use; standard exposed blade lancets and safety type lancets (typically with a spring-loaded auto-retracting blade.)

Question: What is OSHA's position on the use of lancet or lancing devices without safety-engineered features in the performance of finger prick blood sampling in the workplace? Is the use of standard exposed blade lancets acceptable in the workplace for finger prick blood sampling, assuming all other precautions for the use and disposal of sharps devices are followed?

Response: OSHA's bloodborne pathogens standard requires that employers use engineering and work practice controls to eliminate occupational exposure or reduce it to the lowest feasible extent [29 CFR 1910.1030(d)(2)(i)]. In order to prevent accidental needlestick injuries, employers must provide lancets with safety-engineered features for employees who perform finger prick blood sampling in the workplace (e.g., healthcare workers), unless the use of those devices is somehow contraindicated in a particular disease. As always, if using a safer device compromises either patient safety or medical integrity, its use would not be required.

As you may know, the Bloodborne Pathogens Standard, 29 CFR 1910.1030, does not apply to the self-administered personal tests by employees or residents of an establishment. An employee who is diabetic, for instance, may have the need to self-administer finger pricks to periodically test his/her own blood glucose level. Likewise, in some residential settings (e.g., group homes, assisted living or, in certain situations, nursing care facilities), the residents themselves may also self-test and have the need to use lancets. Self-testing with standard lancets, whether done by employees or residents at a workplace setting, would not be covered. The improper disposal of standard lancets or other needles used by those who self-test and/or self-administer medication however, can create a safety hazard for maintenance workers, waste handlers, and other staff placing them at risk for exposures to bloodborne pathogens including HIV/AIDS, hepatitis B, and hepatitis C from needlestick injuries. Therefore, OSHA recommends that employers require employees and residents to appropriately discard of their used sharps, rather than allowing them to be discarded in regular office trash. Providing sharps containers for proper disposal or encouraging the use of commercially available sharps containers manufactured and marketed for home use would be appropriate ways to assure safe disposal.

Please be aware that each state is entitled to adopt its own OSHA-approved occupational safety and health plan that must be at least as effective as that of Federal OSHA. California has adopted such a program. As one of the states with its own OSHA-approved occupational safety and health plan, the California Department of Industrial Relations, Division of Occupational Safety and Health, could adopt a more stringent interpretation of CFR 1910.1030 than that of Federal OSHA. You may contact the state for its own interpretation regarding use of lancets in the workplace.

Division of Occupational Safety and Health
1515 Clay Street, Suite 1901
Oakland, CA 94612
PH: (510) 286-7000
FAX: (510) 286-7037

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