Online Program

Protecting Health Care Workers from Infectious Disease: Experience with Cal/OSHA's Aerosol Transmissible Disease Standard

Monday, November 2, 2015 : 11:34 a.m. - 11:50 a.m.

Deborah Gold, MPH, CIH, retired Deputy Chief for Health, Cal/OSHA, Pacifica, CA
Infectious diseases, such as tuberculosis, have long been a hazard to health care workers (HCWs). In 2003, HCWs bore the brunt of the SARS outbreak in several countries. Other infectious disease challenges have included Methicillin-resistant Staphylococcus aureus (MRSA), drug resistant TB, H1N1, and recently Ebola. In 1991 OSHA adopted the Bloodborne Pathogens Standard, the first major standard to specifically address infectious diseases. Federal OSHA did not succeed in promulgating its 1997 proposed TB standard, but in 2009 the Cal/OSHA Aerosol Transmissible Disease standard was adopted. This standard addressed protection of workers in health care, laboratories, emergency services, corrections, drug treatment programs, and similar environments. A companion standard addressed protection of workers from zoonotic diseases.

After 5 years, California’s ATD Standard remains a unique standard in the U.S. Enforcement of the ATD Standard has involved a high degree of coordination and cooperation with public health agencies. Investigations revealed a number of common problems in hospitals, laboratories, corrections, and other establishments covered by the standard, many of which also weren’t complying with existing public health regulations and guidelines. Disease exposures investigated by Cal/OSHA during the past five years included influenza, meningitis, measles, and tuberculosis. The ATD standard has allowed Cal/OSHA to require a higher level of protection for California HCWs than has been enforced in other jurisdictions

This presentation will discuss some Cal/OSHA investigations, the lessons learned, and how this information could be used by other jurisdictions in protecting health care workers and in adopting similar regulations.

Learning Areas:

Occupational health and safety
Protection of the public in relation to communicable diseases including prevention or control
Provision of health care to the public

Learning Objectives:
Explain recent infectious disease hazards to health care workers. Describe cooperative investigations conducted in California by public health and occupational health agencies. Understand the impact and limitations of Cal/OSHA’s standard, and what could be done to improve it.

Keyword(s): Tuberculosis, Hospitals

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I was the principal author of California's Aerosol Transmissible Disease Standard and participated in, directed, or reviewed investigations conducted under the standard from 2009-2014. I was also the main point of contact with public health departments in developing and enforcing the standard, and conducting joint investigations.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.