In the United States, most workers are covered by the Occupational Safety and Health Act, which provides the legal framework for the work of the Occupational Safety and Health Administration (OSHA). Link

Covered employers and employees are subject to regulations established by OSHA.[1] The general duty clause of the OSHA Act makes it illegal for an employer to expose workers to "recognized hazards."[2]

OSHA Inspections

Over 70% of OSHA inspections are unannounced. Resulting in an average fine of $2300.00, penalties of up to $70,000.00 may be imposed for each willful violation.[3] A record of the violation is also listed in the OSHA database, increasing the likelihood of a re-inspection of that facility.

An inspection begins when the Compliance Officer arrives at the worksite, usually unannounced (unless the visit is scheduled due to a catastrophe or fatality investigation). It is a violation of law to announce a programmed inspection. OSHA does not collect fines and penalties at the time of inspection. Anyone who tries to collect money at an inspection is not an OSHA representative.

The Compliance Officer may inspect the workplace for all OSHA standards, not just the Bloodborne Pathogens Standard. For instance, an inspection related to complaints about air quality in a sushi restaurant or private school may also include checking for compliance with the Bloodborne Pathogens Standard. The Compliance Officer indicates any and all unsafe working conditions to the employer as they are observed during an inspection tour.

After the inspection tour, there is a closing conference. All unsafe or unhealthful conditions are discussed, as well as all violations for which a citation may be issued or recommended. The Compliance Officer does not indicate any proposed penalties at the closing conference. Instead, the OSHA area director will issue penalties after reviewing a full report. The closing conference can also include employees or their representatives.

Citations, Violations, and Penalties

The OSHA Area Director issues Citations and decides what, if any, penalties will be proposed. Citations inform the employer and employees of the regulations and standards alleged to have been violated and of the proposed length of time they have to correct the problem(s). Citations are sent by certified mail. The employer must post a copy of each Citation at or near the place the violation occurred. The Citation must be posted for 3 days or until the violation is fixed, whichever is longer.

Violation Categories:

� Other Than Serious Violations -- A violation directly related to job safety and health, but one that would probably not caause death or serious physical harm. A penalty of up to $7,000 may be issued for each violation.

� Serious Violation -- A violation with substantial probability that death or serious physical harm could result and that the employer knew, or should have known, about. A mandatory penalty of $7,000 for each violation.

� Willful Violation -- A violation that the employer committed intentionally and knowingly. Penalties of up to $70,000 may be imposed for each willful violation, with a minimum penalty of $5,000 for each violation. If a willful violation results in the death of an employee, employers can also be punished by a court-imposed fine or by imprisonment for up to 6 months, or both.

� Repeat Violation -- A violation of a standard where, upon re- inspection, a similar violation is found. Repeat violations can bring a fine of up to $70,000 for each violation.

� Failure to Correct Prior Violation -- A civil penalty of up to $70,000 may be imposed for e4ach day the violation continues beyond the prescribed date for its correction. At $70,000 per violation, it doesn't take long for recalcitrant organizations to reach several hundred thousand dollars worth of penalties and fines. Moreover, OSHA violations, fines and penalties are not confidential. They are often reported in the media. A news report that a major organization had a $250,000 OSHA violation for failing to follow safety regulations could, for instance, be a public relations disaster.

BLOODBORNE PATHOGENS (BBP)

Bloodborne Pathogens means pathogenic microorgan- isms that are present in human blood and can cause disease in humans. These pathogens include, but are not limited to, hepatitis B virus (HBV) and human immunodeficiency virus (HIV).[4]

Occupational Exposure means 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.[5]

Methods of Compliance[6]:

Universal precautions shall be observed to prevent contact with blood or other potentially infectious materials. Under circumstances in which differentiation between body fluid types is difficult or impossible, all body fluids shall be considered potentially infectious materials.[7]

Equipment which may become contaminated with blood or other potentially infectious materials shall be examined prior to servicing or shipping and shall be decontaminated as necessary, unless the employer can demon- strate that decontamination of such equipment or portions of such equip- ment is not feasible.[8]

Information and Training:

Employers shall ensure that all employees with occupational exposure participate in a training program which must be provided at no cost to the employee and during working hours.[9]

Training shall be provided as follows:

� At the time of initial assignment to tasks where occupational exposure may take place;[10]

� Within 90 days after the effective date of the standard;[11] and

� At least annually thereafter.[12]

For employees who have received training on bloodborne pathogens in the year preceding the effective date of the standard, only training with respect to the provisions of the standard which were not included need be provided.[13]

Annual training for all employees shall be provided within one year of their previous training.[14]

Employers shall provide additional training when changes such as modifi- cation of tasks or procedures or institution of new tasks or procedures affect the employee's occupational exposure. The additional training may be limited to addressing the new exposures created.[15]

Material appropriate in content and vocabulary to educational level, literacy, and language of employees shall be used.[16]

The training program shall contain at a minimum the following elements:

� An accessible copy of the regulatory text of this standard and an explanation of its contents;

� A general explanation of the epidemiology and symptoms of bloodborne diseases;

� An explanation of the modes of transmission of bloodborne pathogens;

� An explanation of the employer's exposure control plan and the means by which the employee can obtain a copy of the written plan;

� An explanation of the appropriate methods for recognizing tasks and other activities that may involve exposure to blood and other poten- tially infectious materials;

� An explanation of the use and limitations of methods that will prevent or reduce exposure including appropriate engineering controls, work practices, and personal protective equipment;

� Information on the types, proper use, location, removal, handling, decontamination and disposal of personal protective equipment;

� An explanation of the basis for selection of personal protective equipment;

� Information on the hepatitis B vaccine, including information on its efficacy, safety, method of administration, the benefits of being vaccinated, and that the vaccine and vaccination will be offered free of charge;

� Information on the appropriate actions to take and persons to contact in an emergency involving blood or other potentially infectious materials;

� An explanation of the procedure to follow if an exposure incident occurs, including the method of reporting the incident and the medical follow-up that will be made available;

� Information on the post-exposure evaluation and follow-up that the employer is required to provide for the employee following an exposure incident;

� An explanation of the signs and labels and/or color coding required by paragraph (g)(1); and

� An opportunity for interactive questions and answers with the person conducting the training session.[17]

The person conducting the training shall be knowledgeable in the subject matter covered by the elements contained in the training program as it relates to the workplace that the training will address.

Medical Records:

The employer shall establish and maintain an accurate record for each employee with occupational exposure, in accordance with 29 CFR 1910.1020.[18]

This record shall include:

� The name and social security number of the employee;[19]

� A copy of the employee's hepatitis B vaccination status including the dates of all the hepatitis B vaccinations and any medical records relative to the employee's ability to receive vaccination as required by paragraph (f)(2);[20]

� A copy of all results of examinations, medical testing, and follow-up procedures as required by paragraph (f)(3);[21]

� The employer's copy of the healthcare professional's written opinion as required by paragraph (f)(5);[22] and

� A copy of the information provided to the healthcare professional as required by paragraphs (f)(4)(ii)(B)(C) and (D).[23]

Training Records:

Training records shall include the following information:

� The dates of the training sessions;[24]

� The contents or a summary of the training sessions;[25]

� The names and qualifications of persons conducting the training;[26] and

� The names and job titles of all persons attending the training sessions.[27]

Training records shall be maintained for 3 years from the date on which the training occurred.[28]

Workers in many different occupations are at risk of exposure to bloodborne pathogens. First aid team members, janitors, food service workers, and medical staff are but a few examples of workers who may be at risk of ex- posure.

OSHA Fines and Penalties Related to BBP:

EMPLOYER FINED $52,000 FOR ALLEGEDLY NOT PROVIDING PROTECTIVE EQUIPMENT TO WORKERS WHO HANDLE "CONTAMINATED LAUNDRY" AND OTHER VIOLATIONS Link

OSHA PROPOSES $42,000 FINE FOR BLOODBORNE PATHOGENS AND OTHER VIOLATIONS Link

OSHA FINES AMBULANCE COMPANY $304,700 FOR BLOODBORNE PATHOGENS VIOLATIONS Link

OSHA SLAPS $60,100 FINE ON BOSTON AMBULANCE FIRM: AGENCY GETS SERIOUS ABOUT BLOODBORNE PATHOGENS (OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION) Link

HELENA LABORATORIES AGREES TO PAY $137,100 FOR BLOODBORNE PATHOGEN VIOLATIONS Link

�IT IS CLEAR THAT OSHA IS VIGOROUSLY APPLYING THE STANDARD AND IS PREPARED TO ISSUE FINES. VIOLATIONS OF THE BLOODBORNE PATHOGENS STANDARD CAN CARRY UP TO A $7000 FINE PER INSTANCE.� Link

�VIOLATION OF THE BLOODBORNE PATHOGEN STANDARD MAY RESULT IN PENALTIES OF UP TO $70,000, DEPENDING ON THE SEVERITY OF THE INFRACTION. CRIMINAL PENALTIES ARE ALSO POSSIBLE FOR WILLFUL VIOLATIONS THAT RESULT IN WORKER DEATH.� Link

BLOODBORNE PATHOGENS TOP CATEGORY CITED BY OSHA DURING INSPECTION OF NURSING FACILITIES Link

General Industry top 10: Bloodborne Pathogens (1910.1030) - 2,508 violations and $1,272,355 in penalties. Link

CARDIO-PULMONARY RESUSCITATION & DEFIBRILLATION

OSHA

While universal AED training standards have not yet been adopted by OSHA, the practice of implementing AEDs has been applauded.

OSHA's endorsement of AED's in the workplace (PDF) Link

FEDERAL AED LAW

On October 26, 2000, Congress passed into law the Public Health Improvement Act which contains the Cardiac Arrest Survival Act (CASA). CASA provides for placement of AEDs in all federal public buildings. Good Samaritan immunity to applies to trained rescuers who may use the devices. It also allocates $25 Million dollars for placement of AEDs in rural areas.

1999 Cardiac Arrest Survival Act (PDF) Link

Summary of AED Actions in the 107th Congress (PDF) Link

Model Protocol: AED, U.S. Depart. of Energy Link

States Laws Regarding AED's

Florida was the first state to enact a broad public access AED law (Chapter 34 of 1997). As of mid-2001, all fifty states have adopted defibrillator laws or regulations.

Maine became the 50th state in June 2001.

Also in 2001, Alabama, Connecticut, Florida, Georgia and Oregon passed additional laws clarifying or expanding on earlier language.

In 2002 Arizona, California, New Hampshire and New York enacted legislation, all amending existing provisions concerning the regu- lation of automated external defibrillators.

Nevada Requires AEDs in High Schools and Public Facilities Link

Arizona enacted a measure that will require any state building con- structed or renovated at a cost of at least $250,000 to be equipped with automated external defibrillators. SB1070 requires that the Joint Legislative Budget Committee and the Governor's Office of Strategic Planning and Budgeting should include funding for the placement of automated external defibrillators in capital budgets for new state buildings each fiscal year. The provisions in the act become effective after June 30, 2003. Link

Utah updated its AED law in 2003 by establishing a statewide reg- istry. Link

Virginia updated AED laws in 2003 by deleting the requirement for registration. Link

In New York, legislators enacted new requirements for public school facilities to provide and maintain on-site AED equipment. Assembly Bill 8779, requires that all school sponsored activities have at least one staff person who has been trained in the use of the device present.

Litigation Risk

Even if not covered, there may be a litigation risk where the company knew of the potential hazard and knew of a solution but failed to implement it.

FIRST AID

OSHA First Aid Standard:

First Aid should is a vital part of all safety and health programs. Prompt, properly administered First Aid care can mean the difference between life and death. The OSHA First Aid standard 29 CFR 1910.151 reads:

"The employer shall ensure the ready availability of medical personnel for advice and consultation on matters of plant health. In the absence of an infirmary, clinic or hospital in near proximity to the workplace that is used for the treatment of all injured employees, a person or persons shall be adequately trained to render first aid. Adequate first aid supplies shall be readily available. Where the eyes or body of any person may be exposed to injurious corrosive materials, suitable facilities for quick drenching or flushing of the eyes and body shall be provided within the work area for immediate emergency use."

Penalties & Liabilities:

FATAL ACCIDENT RESULTS IN $80,150 FINE FOR EUFAULA PULPWOOD COMPANY Link

�CALIFORNIA EMPLOYEES NOW HAVE THE RIGHT TO TAKE EMPLOYERS TO COURT OVER LABOR CODE VIOLATIONS SUCH AS SAFETY AND WORKING CONDITIONS.� Link

New Jersey Occupational Safety Law

The New Jersey PEOSH program covers the workplace safety and health of public sector employees only. Private sector employees in New Jersey are covered by Federal OSHA. Link

New York Occupational Safety Law

In New York State, state and local government workers are under the juris- diction of the Public Employee Safety and Health bureau of the New York State Department of Labor (PESH). PESH operates under the authority of Sections 27 to 32 of the New York State Labor Law. It enforces standards that are almost identical to OSHA standards. Workers who are not covered by PESH are covered by Federal OSHA.

Disclaimer:

Please seek the advice of an attorney to determine whether any state, local, or municipal regulations pertaining to CPR and AED training would include your organization. This site is maintained for informational purposes only, and is not to be construed as a substitute for the advice of counsel.

[1] Or by other federal agencies with specialized jurisdictions, such as the Mine Safety and Health Administration and the Coast Guard. The few exceptions include self-employed persons, privately employed domestic workers, and workers on �family-run� farms.

[2]Link

[3] A willful violation is one that an employer knowingly commits or commits with plain indifference to the law. The employer either knows that what he or she is doing constitutes a violation, or is aware that a hazardous condition existed and made no reasonable effort to eliminate it.

[4]Link

[5]Link

[6] 1910.1030(d)(1)

[7]Link

[8] 1910.1030(d)(2)(xiv)

[9] 1910.1030(g)(2)(i)

[10] 1910.1030(g)(2)(ii)(B)

[11] 1910.1030(g)(2)(ii)(C)

[12] 1910.1030(g)(2)(iii)

[13] 1910.1030(g)(2)(iv)

[14] 1910.1030(g)(2)(v)

[15] 1910.1030(g)(2)(vi)