Aerosol Transmissible Diseases - Referring Employers
Cal/OSHA recently adopted a new standard, CCR T8 § 5199, regulating employee exposure to aerosol transmissible diseases (ATDs). These diseases can be spread through the air in the form of small particles or droplets. Influenza, tuberculosis, and severe acute respiratory syndrome (SARS) are just a few examples of aerosol transmissible diseases. The standard became effective August 5, 2009. There is a Loss Control Bulletin covering the entire standard entitled Aerosol Transmissible Diseases – Summary.
| An Aerosol Transmissible Disease (ATD) or Aerosol Transmissible Pathogen (ATP) is a disease or pathogen for which droplet or airborne precautions are recommended. These are listed in Appendix A of the standard CCR T8 §5199. |
Referring Employers
- Screen patients for airborne infectious diseases
- Refer known or suspected cases
- Do not provide treatment other than first aid, initial treatment, screening or referral
- Do not provide airborne infection isolation, medical transportation or housing for known or suspected cases
Only some parts of an ATD Exposure Control Plan are required for Referring Employers. Referring Employers are responsible for:
- Designating a Program Administrator and a back-up person who will write and administer the ATD Exposure Control Plan. The administrator and back-up person will be responsible for the Plan.
- Determining and documenting which job categories have occupational exposure.
- Developing and documenting infection control procedures for the cleaning and disinfection of work areas, vehicles, and equipment that may become contaminated with ATPs and pose an infection risk to employees.
- Defining and documenting source control and infection control procedures that incorporate the recommendations contained in Respiratory Hygiene/Cough Etiquette in Health Care Settings. Source control measures are those that minimize airborne particle or droplet dispersal from the patient. Procedures must include the means of communicating these measures to patients.
- Establishing and documenting certain patient screening procedures.
- Establishing procedures for the referral of patients to a health care provider for further evaluation.
- Transferring cases and suspected cases within 5 hours of their identification (with some exceptions).
- Establishing, implementing and maintaining effective written procedures for:
- Communicating the infectious disease status of patients to those who would receive the patient
- Establishing procedures that reduce the risk of transmission of ATDs. These procedures could include:
- Placing the patient in a separate room.
- Providing separate ventilation or filtration to the area.
- Requiring employees to wear a CCR T8 §5144 – compliant respirator when in contact with a patient who is not using source control. (Law enforcement personnel who transport a person requiring referral can avoid wearing a respirator if their car or similar cars pass a ventilation test described in the standard.)
- Communicating with employees, other employers and the local health officer regarding the diagnosis of referred patients.
- Establishing a medical surveillance system for employees to include:
- Vaccinations
- Procedures for exposure incidents
- Latent tuberculosis infection surveillance
- Flu shots during flu season
- Training employees with potential occupational exposures prior to assignment, when changes occur and at least annually.
- Maintaining appropriate records.
- Reviewing the program annually and correcting deficiencies with employee input.
Employers are encouraged to refer to the regulations and any guidance documents Cal/OSHA may have available at www.dir.ca.gov/dosh. You may also contact your State Fund Loss Control Consultant and ask for an industrial hygiene consultation.
References:
The above evaluations and/or recommendations are for general guidance only and should not be relied upon for legal compliance purposes. They are based solely on the information provided to us and relate only to those conditions specifically discussed. We do not make any warranty, expressed or implied, that your workplace is safe or healthful or that it complies with all laws, regulations or standards.
