Training At-Risk Employees | Bloodborne Pathogens

All employees with a potential for exposure must be provided with adequate training and information including:

1. General explanations of the modes of transmission, symptoms, epidemiology, warning signals relating to possible exposure, and procedures to follow if exposure occurs.

2. Appropriate methods for recognizing tasks that may involve exposure to blood or other potentially infectious materials and the use and limitations of practices that would reduce exposure. This includes engineering controls, work practices, and personal protective equipment.

3. Information on the use, location, and decontamination/disposal of personal protective equipment and clothing, and information on what to do in an emergency.

Each occupationally exposed employee must be given free BBP information and training at the time of initial assignment and at least once a year thereafter. The training must be provided during working hours. Additional training is needed when existing tasks are modified or new tasks are required which affect the employees' occupational exposure.

A variety of written material, oral presentations, films, videos, computer programs, or audiotapes can be used in the training program. The information that is presented must be appropriate to the employee's education, literacy level, and language.

OSHA requires that the trainer provide opportunities for interactive questions and answers with trainees. That means that training done solely with a video or film without a discussion period would be a violation of the BBP standard. However, direct access to a qualified trainer via a telephone hot line or an immediate e-mail answer is an acceptable alternative.

Training Program Elements

Training sessions must be comprehensive, including information on bloodborne pathogens as well as on OSHA regulations relating to this standard and the employer's exposure control plan.

At a minimum, the training program must include the following elements:

• An accessible copy and explanation of the standard;

• 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 written exposure control plan and how to obtain a copy;

• An explanation of how to recognize events that may involve exposure to blood and other potentially infectious materials;

• An explanation of the basis for selecting personal protective equipment, including information on the types, selection, proper use, location, removal, handling, decontamination, and disposal of personal protective equipment;

• An explanation of the use and limitations of safe work practices, engineering controls, and personal protective equipment;

• Information on hepatitis B vaccination, such as safety, benefits, effectiveness, and availability;

• An explanation of the procedures to follow if an exposure occurs, including methods of reporting and the medical follow-up that will be made available;

• Information on the post-exposure evaluation and follow-up required in the event of an exposure, and information on emergencies that relate to blood or other potentially infectious materials, follow-up procedures, and medical counseling;

• An explanation of information on warning signs, labels, and color-coding.

Trainer Qualifications

The person conducting the training must be knowledgeable in the subject matter, especially as it relates to the workplace that the training addresses. Trainer competency should be based on the completion of specialized courses, degree programs, or work experience.

Possible trainers include a variety of healthcare professionals such as infection control practitioners, nurse practitioners, registered nurses, occupational health professionals, physician's assistants, and emergency medical technicians.

Non-healthcare professionals, such as but not limited to, industrial hygienists, epidemiologists, or professional trainers, may conduct the training provided they are knowledgeable in the subject matter covered by the elements contained in the training program as it relates to the workplace.

Matching Training to Employees | Training Requirements

While all employees are entitled to know as much as possible about the safety and health hazards to which they are exposed, and employers should attempt to provide all relevant information and instruction to all employees, the resources for such an effort frequently are not, or are not believed to be, available. Thus, employers are often faced with the problem of deciding who is in the greatest need of information and instruction.

One way to differentiate between employees who have priority needs for training and those who do not is to identify employee populations which are at higher levels of risk. The nature of the work will provide an indication that such groups should receive priority for information on occupational safety and health risks.

Identifying Employees at Risk

One method of identifying employee populations at high levels of occupational risk (and thus in greater need of safety and health training) is to pinpoint hazardous occupations. Even within industries which are hazardous in general, there are some employees who operate at greater risk than others. In other cases the hazardousness of an occupation is influenced by the conditions under which it is performed, such as noise, heat or cold, or safety or health hazards in the surrounding area. In these situations, employees should be trained not only on how to perform their job safely but also on how to operate within a hazardous environment.

A second method of identifying employee populations at high levels of risk is to examine the incidence of accidents and injuries, both within the company and within the industry. If employees in certain occupational categories are experiencing higher accident and injury rates than other employees, training may be one way to reduce that rate. In addition, thorough accident investigation can identify not only specific employees who could benefit from training but also identify company-wide training needs.

Research has identified the following variables as being related to a disproportionate share of injuries and illnesses at the worksite on the part of employees:

1. The age of the employee (younger employees have higher incidence rates).

2. The length of time on the job (new employees have higher incidence rates).

3. The size of the firm (in general terms, medium-size firms have higher incidence rates than smaller or larger firms).

4. The type of work performed (incidence and severity rates vary significantly by SIC Code).

5. The use of hazardous substances (by SIC Code).

These variables should be considered when identifying employee groups for training in occupational safety and health.

In summary, information is readily available to help employers identify which employees should receive safety and health information, education and training, and who should receive it before others. Employers can request assistance in obtaining information by contacting such organizations as OSHA Area Offices, the Bureau of Labor Statistics, OSHA-approved State programs, State onsite consultation programs, the OSHA Office of Training and Education, or local safety councils.

Training Employees at Risk

Determining the content of training for employee populations at higher levels of risk is similar to determining what any employee needs to know, but more emphasis is placed on the requirements of the job and the possibility of injury. One useful tool for determining training content from job requirements is the Job Hazard Analysis. This procedure examines each step of a job, identifies existing or potential hazards, and determines the best way to perform the job in order to reduce or eliminate the hazards. Its key elements are:

1. job description,

2. job location,

3. key steps (preferably in the order in which they are performed),

4. tools, machines and materials used,

5. actual and potential safety and health hazards associated with these key job steps, and

6. safe and healthful practices, apparel, and equipment required for each job step.

Material Safety Data Sheets (MSDS) can also provide information for training employees in the safe use of materials. These data sheets, developed by chemical manufacturers and importers, are supplied with manufacturing or construction materials and describe the ingredients of a product, its hazards, protective equipment to be used, safe handling procedures, and emergency first-aid responses.

The information contained in these sheets can help employers identify employees in need of training (i.e., workers handling substances described in the sheets) and train employees in safe use of the substances. Material Safety Data Sheets are generally available from suppliers, manufacturers of the substance, large employers who use the substance on a regular basis, or they can be developed by employers or trade associations. MSDS are particularly useful for those employers who are developing training on chemical use as required by OSHA's Hazard Communication Standard.

Conclusion

In an attempt to assist employers with their occupational health and safety training activities, OSHA has developed a set of training guidelines in the form of a model. This model is designed to help employers develop instructional programs as part of their total education and training effort. The model addresses the questions of who should be trained, on what topics, and for what purposes. It also helps employers determine how effective the program has been and enables them to identify employees who are in greatest need of education and training.

The model is general enough to be used in any area of occupational safety and health training, and allows employers to determine for themselves the content and format of training. Use of this model in training activities is just one of many ways that employers can comply with the OSHA standards that relate to training and enhance the safety and health of their employees.

Employee Responsibilities and Rights | OSHA

Although OSHA does not cite employees for violations of their responsibilities, each employee "shall comply with all occupational safety and health standards and all rules, regulations, and orders issued under the Act" that are applicable. Employee responsibilities and rights in states with their own occupational safety and health programs are generally the same as for workers in federal OSHA states.

Responsibilities

As an employee, you should:

• Read the OSHA poster at the jobsite.

• Comply with all applicable OSHA standards.

• Follow all employer safety and health rules and regulations, and wear or use prescribed protective equipment while engaged in work.

• Report hazardous conditions to the supervisor.

• Report any job-related injury or illness to the employer, and seek treatment promptly.

• Cooperate with the OSHA compliance officer conducting an inspection if he or she inquires about safety and health conditions in your workplace.

• Exercise your rights under the Act in a responsible manner.

11(c) Rights: Protection for using Rights

Employees have a right to seek safety and health on the job without fear of punishment. That right is spelled out in Section 11(c) of the Act.

The law says employers shall not punish or discriminate against workers for exercising rights such as:

• Complaining to an employer, union, OSHA or any other government agency about job safety and health hazards.

• Filing safety or health grievances.

• Participating on a workplace safety and health committee or in union activities concerning job safety and health.

• Participating in OSHA inspections, conferences, hearings or other OSHA-related activities.

Discrimination for using Rights

If an employee is exercising these or other OSHA rights, the employer is not allowed to discriminate against that worker in any way, such as through firing, demotion, taking away seniority or other earned benefits, transferring the worker to an undesirable job or shift, or threatening or harassing the worker.

If the employer has knowingly allowed the employee to do something in the past (such as leaving work early), he or she may be violating the law by punishing the worker for doing the same thing following a protest of hazardous conditions. If the employer knows that a number of workers are doing the same thing wrong, he or she cannot legally single out for punishment the worker who has taken part in safety and health activities.

Although there is nothing in the OSHA law that specifically gives an employee the right to refuse to perform an unsafe or unhealthful job assignment, OSHA's regulations, which have been upheld by the U.S. Supreme Court, provide that an employee may refuse to work when faced with an imminent danger of death or serious injury. The conditions necessary to justify a work refusal are very stringent, however, and a work refusal should be an action taken only as a last resort. If time permits, the unhealthful or unsafe condition should be reported to OSHA or another appropriate regulatory agency.

Workers believing that they have been punished for exercising safety and health rights must contact the nearest OSHA office within 30 days of the time they learn of the alleged discrimination. A representative of the employee's choosing can file the 11(c) complaint for the worker. Following a complaint, OSHA will contact the complainant and conduct an indepth interview to determine whether an investigation is necessary.

If evidence supports the conclusion that the employee has been punished for exercising safety and health rights, OSHA will ask the employer to restore that worker's job, earnings, and benefits. If the employer declines to enter into a voluntary settlement, OSHA may take the employer to court. In such cases, an attorney of the Department of Labor will conduct litigation on behalf of the employee to obtain this relief.

Section 405 of the Surface Transportation Assistance Act (STAA) was enacted on January 6, 1983, and provides protection from reprisal by employers for truckers and certain other employees in the trucking industry involved in activity related to interstate commercial motor vehicle safety and health. Secretary of Labor's Order No. 9-83 (48 FR 35736, August 5, 1983) delegated to the Assistant Secretary of OSHA the authority to investigate and to issue findings and preliminary orders under Section 405.

Employees who believe they have been discriminated against for exercising their rights under Section 405 can file a complaint with OSHA within 180 days of the incident. The Secretary will then investigate the complaint, and within 60 days after it was filed, issue findings as to whether there is a reason to believe Section 405 has been violated.

If the Secretary finds that a complaint has merit, he/she also will issue an order requiring, where appropriate, abatement of the violation, reinstatement with back pay and related compensation, payment of compensatory damages, and the payment of the employee's expenses in bringing the complaint. Either the employee or employer may object to the findings. If no objection is filed within 30 days, the findings and order are final. However, if a timely filed objection is made, the objecting party is entitled to a hearing on the objection before an Administrative Law Judge of the Department of Labor.

Within 120 days of the hearing the Secretary will issue a final order. A party aggrieved by the final order may seek judicial review in a court of appeals within 60 days of the final order.

The following activities of truckers and certain employees involved in interstate commercial motor vehicle operation are protected under Section 405:

• Filing of safety or health complaints with OSHA or other regulatory agency relating to a violation of a commercial motor vehicle safety rule, regulation, standard, or order.

• Instituting or causing to be instituted any proceedings relating to a violation of a commercial motor vehicle safety rule, regulation, standard, or order.

• Testifying in any such proceedings relating to the above items.

• Refusing to operate a vehicle when such operation constitutes a violation of any federal rules, regulations, standards or orders applicable to commercial motor vehicle safety or health; or because of the employee's reasonable apprehension of serious injury to himself or the public due to the unsafe condition of the equipment.

Complaints under Section 405 are filed in the same manner as complaints under 11(c). The filing period for Section 405 is 180 days from the alleged discrimination, rather than 30 days as under Section 11(c).

The worker does not have to complete any forms. An OSHA staff member will complete the forms, asking what happened and who was involved.

Following a complaint, OSHA investigates. If an employee has been illegally punished for exercising safety and health rights, OSHA asks the employer to restore that worker's job earning and benefits. If necessary, and if it can prove discrimination, OSHA takes the employer to court. In such cases the worker does not pay any legal fees.

If a state agency has an OSHA-approved state program, employees may file their complaint with either federal OSHA or the state agency under its laws.

Other Rights

As an employee, you have the right to:

• Review copies of appropriate OSHA standards, rules, regulations and requirements that the employer should have available at the workplace.

• Request information from your employer on safety and health hazards in the area, on precautions that may be taken, and on procedures to be followed if an employee is involved in an accident or is exposed to toxic substances.

• Receive adequate training and information on workplace safety and health hazards.

• Request the OSHA area director to conduct an inspection if you believe hazardous conditions or violations of standards exist in your workplace.

• Have your name withheld from your employer, upon request to OSHA, if you file a written and signed complaint.

• Be advised of OSHA actions regarding your complaint and have an informal review, if requested, of any decision not to inspect or to issue a citation.

• Have your authorized employee representative accompany the OSHA compliance officer during the inspection tour.

• Respond to questions from the OSHA compliance officer, particularly if there is no authorized employee representative accompanying the compliance officer.

• Observe any monitoring or measuring of hazardous materials and have the right to see these records, as specified under the Act.

• Have your authorized representative, or yourself, review the Log and Summary of Occupational Injuries (OSHA 200 or OSHA 300/300A) at a reasonable time and in a reasonable manner.

• Request a closing discussion with the compliance officer following an inspection.

• Submit a written request to NIOSH for information on whether any substance in your workplace has potentially toxic effects in the concentration being used, and have your name withheld from your employer if you so request.

• Object to the abatement period set in the citation issued to your employer by writing to the OSHA area director within 15 working days of the issuance of the citation.

• Be notified by your employer if he or she applies for a variance from an OSHA standard, and testify at a variance hearing and appeal the final decision.

• Submit information or comment to OSHA on the issuance, modification, or revocation of OSHA standards and request a public hearing.